心血管病危害严重，指南推荐的基于风险的一级预防策略和标准化的干预工具包在我国人群中缺乏实际应用和干预效果的证据，采用阶梯设计的整群随机对照试验评价公共卫生干预措施在国际上发展迅速，但目前国内研究较少。本研究拟采用该设计基于中国鄞州电子健康档案研究已建立的心血管病风险评估和动态预警系统，在社区人群中通过随机化分组逐步（阶梯式）实施“风险评估-动态预警-规范干预”一体化的强化干预方案（即通过风险评估工具进行人群分层，针对高危人群进行动态预警，采用世界卫生组织推荐的HEARTS工具包规范化干预），与目前常规干预方案比较，评价其降低人群主要心血管事件（脑卒中和冠心病）发病和死亡的实际干预效果。通过随机对照试验的严谨设计，旨在解决“目前针对中国人群的心血管病一级预防策略和社区干预方案缺乏高质量证据”这一核心科学问题，不仅可为我国进一步制定慢性病防治策略提供依据，还能实现成果在公共卫生领域的转化应用。

Cardiovascular diseases (CVD), including coronary heart disease (CHD) and stroke, are leading causes of death worldwide. Risk-based strategy for primary prevention of CVD by the guidelines and the effectiveness of standardized intervention packages have insufficient evidence in Chinese population. On the other hand, stepped-wedge cluster randomized controlled trials are increasingly being used globally to evaluate public health interventions; however, few studies were from China. In this study, a stepped-wedge cluster randomized controlled trial, named “Cardiovascular Risk assessment and dynamIc monitoring based prevention Trial for prImary Care quALity evaLuation in Yinzhou, CRITICALLY”, is designed to evaluate the effect of risk-based cardiovascular intervention package by dynamic monitoring the Chinese population using quantitative risk assessment tools and the World Health Organization HEARTS technical package for primary care. Compared with usual care or routine intervention, whether the intensive intervention package (i.e., stratification of population through CVD risk assessment tools, dynamic monitoring for high-risk population, and standardized intervention using the HEARTS package recommended by the World Health Organization) could decrease morbidity and mortality of CVD (stroke and CHD) in Chinese population is the key question. Using rigorous design of the randomized controlled trial, this proposed study could provide solid evidence on the primary prevention of cardiovascular diseases in Chinese. In the meanwhile, the plan for implementation will address local and contextually relevant challenges and is more likely to produce translatable evidence to solve an important public health problem in China.