A nurse-led intervention to promote physical activity in sedentary older adults with cardiovascular risk factors: a randomized clinical trial (STEP-IT-UP study)

Background Regular physical activity should constitute the essence of treatment in patients with cardiovascular risk factors. We sought to determine the benefits of nurse-led intervention to promote physical activity in sedentary older adults in a primary care setting. Methods A group of 199 sedentary older adults (mean age 62.7 +/- 6.9, 34.2% male) with at least one more cardiovascular risk factor were randomized 1:1 to receive a nurse-led tutorial on lifestyle modification, including pedometer hand-out - with a daily goal of at least 7000 steps - and supporting phone calls (study group), or without a goal or calls (control group). Body weight (BW), resting heart rate, systolic and diastolic blood pressure (SBP/DBP), total cholesterol (TC) and glucose were assessed at baseline and after 3 months. Results Subjects in the study group (n = 86) achieved higher daily step count in comparison to the control group (n = 78), 10,648 +/- 3098 vs. 3589 +/- 2000, p < 0.0001. The study group presented an improvement in all analysed parameters but glucose, including BW (-2.5 +/- 1.9 kg), SBP and DBP (-7.9 +/- 7.6 mmHg and -6.2 +/- 6.5 mmHg) and TC (-14.7 +/- 30.4 mg%), all p < 0.0001. In the control group, all parameters increased or remained unchanged. An inverse correlation between the daily step count and delta of the analysed parameters (r = -0.26 to -0.72, p < 0.001) was found. Conclusion Nurse-led intervention with pedometer, goal setting and supporting phone calls is an effective way to promote physical activity in sedentary older adults and leads to improvement of cardiovascular risk factors within 3 months.