CHANGE IN RISK-FACTORS FOR CORONARY HEART-DISEASE DURING 10 YEARS OF A COMMUNITY INTERVENTION PROGRAM (NORTH KARELIA PROJECT)

CHANGE IN RISK-FACTORS FOR CORONARY HEART-DISEASE DURING 10 YEARS OF A COMMUNITY INTERVENTION PROGRAM (NORTH KARELIA PROJECT)
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DOI:
10.1136/bmj.287.6408.1840
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发表时间:
1983-01-01
影响因子:
105.7
通讯作者:
HUTTUNEN, J
HUTTUNEN, J
中科院分区:
医学1区
文献类型:
--
作者:
PUSKA, P;SALONEN, JT;HUTTUNEN, J

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1972年,芬兰北卡累利阿开始了一项以社区为基础的综合性心血管疾病控制计划。降低吸烟、血清胆固醇浓度和血压是中心中间目标。在1972年至1982年的10年期间,该计划的效果进行了评估,通过检查独立的随机人口样本在开始(1972年)和5(1977年)和10(1982年)年后,无论是在该计划和在一个匹配的参考区域。1972年和1977年研究了10,000多名受试者(参与率约为90%),1982年约有8000名受试者(参与率约为80%)。通过比较30-59岁年龄范围内的基线和5年及10年随访结果,对该计划对风险因素人群平均值的估计影响进行分析。节目效果据估计,在10岁的中年男性人群中,(P < 0.001),平均血清胆固醇浓度降低3%平均收缩压下降3%(P <0.001),平均舒张压下降1%(P < 0.05)。在女性人群中,降低分别为14%(NS [无显著性])、1%(NS)、5%(P < 0.001)和2%(P < 0.05)。在该项目的前5年(1972-1977),该项目有效地降低了主要冠状动脉危险因素的人群平均值。在10年的影响一直持续血清胆固醇浓度和血压,并增加吸烟。
A comprehensive community based program to control cardiovascular diseases was started in North Karelia, Finland, in 1972. Reductions in smoking, serum cholesterol concentrations and blood pressure were among the central intermediate objectives. The effect of the program during the 10 yr period 1972-1982 was evaluated by examining independent random population samples at the outset (1972) and 5 (1977) and 10 (1982) years later both in the program and in a matched reference area. Over 10,000 subjects were studied in 1972 and 1977 (participation rate about 90%) and roughly 8000 subjects in 1982 (participation rate about 80%). Analyses were conducted of the estimated effect of the program on the risk factor population means by comparing the baseline and 5 yr and 10 yr follow-up results in the age range 30-59 yr. The effect of the program (net reduction in North Karelia) at 10 yr among the middle aged male population was estimated to be a 28% reduction in smoking (P < 0.001), a 3% reduction in mean serum cholesterol concentration (P < 0.001), a 3% fall in mean systolic blood pressure (P < 0.001), and a 1% fall in mean diastolic blood pressure (P < 0.05). Among the female population the reductions were, respectively, 14% (NS [not significant]), 1% (NS), 5% (P < 0.001), and 2% (P < 0.05). During the first 5 yr of the project (1972-1977) the program effectively reduced the population mean values of the major coronary risk factors. At 10 yr the effects had persisted for serum cholesterol concentrations and blood pressure and were increased for smoking.