The Ashkelon Hypertension Detection and Control Program (AHDC Program): a community approach to reducing
C Yosefy1, D Dicker, J R Viskoper
1WHO Collaborative Center for Prevention and Treatment of Cardiovascular Disease, Barzilai Medical Center, Campus Ashkelon, Ben-Gurion University, Israel. yosefy@barzi.health.gov.il
Preventive Medicine
|November 26, 2003
Summary
A community outreach program effectively reduced cardiovascular disease mortality by screening adults aged 20-65 for risk factors. This approach, using doctor-nurse teams and non-pharmacological interventions, proved cost-effective in lowering morbidity and mortality.
Area of Science:
- Public Health
- Cardiovascular Medicine
- Preventive Cardiology
Background:
- Blood pressure reduction is critical for preventing cardiovascular (CV) morbidity and mortality.
- Adults aged 20-65 are seldom reached by primary care, necessitating active screening programs.
- An outreach program was developed to screen for and manage CV risk factors in this demographic.
Purpose of the Study:
- To establish a doctor-nurse screening team for identifying high-risk individuals.
- To provide instruction on risk factor control to mitigate CV morbidity and mortality.
Main Methods:
- A 10-year screening program (1980-1990) examined 12,202 subjects (aged 20-65).
- High-risk individuals identified (28.6%) received intensive cardiovascular risk factor control interventions.
- Follow-up focused on blood pressure, weight, smoking, and cholesterol management.
Main Results:
- Significant improvements were observed in blood pressure, weight reduction, and smoking cessation over a 2-year follow-up.
- Standardized mortality ratios for acute myocardial infarction, CV disease, and hypertension showed significant decreases.
- The project demonstrated cost-effectiveness, saving life-years with no additional net cost.
Conclusions:
- A community-based approach utilizing non-pharmacological treatments is feasible and cost-effective.
- Outreach screening and risk factor management can significantly reduce cardiovascular morbidity and mortality.
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