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[The Belgian project for the prevention of cardiovascular diseases: a model of multifactorial prevention]
Insights
This study on heart disease prevention in Belgian men showed that a multifactorial intervention significantly reduced total mortality and coronary heart disease incidence. Health education and workplace counseling effectively lowered coronary risk factors.
Area of Science:
- Cardiovascular Disease Prevention
- Public Health Research
- Epidemiology
Background:
- Coronary heart disease (CHD) poses a significant public health challenge.
- Multifactorial prevention strategies are crucial for managing cardiovascular risk.
- The WHO European Collaborative Trial provided a framework for large-scale CHD prevention research.
Purpose of the Study:
- To evaluate the effectiveness of a multifactorial intervention in preventing coronary heart disease.
- To assess the impact of health education and counseling on CHD risk factors.
- To determine the effect of the intervention on total and coronary mortality.
Main Methods:
- A randomized controlled trial involving 19,409 men aged 40-59.
- Intervention included health education on diet, smoking cessation, weight control, physical activity, and hypertension management.
- Face-to-face counseling was provided at the workplace over 5-6 years.
Main Results:
- The intervention group showed reduced serum cholesterol, fewer cigarettes smoked daily, and lower arterial blood pressure.
- Total mortality was significantly reduced by 17.5% (p = 0.038).
- Coronary heart disease incidence decreased by 24.5% (p = 0.031), with a 26.1% reduction in non-fatal myocardial infarction (p = 0.030).
Conclusions:
- A multifactorial intervention program can effectively reduce coronary risk factors and improve health outcomes.
- Workplace-based health education and counseling are valuable tools for cardiovascular disease prevention.
- The findings support the implementation of comprehensive strategies to combat coronary heart disease.
Abstract:
Résults are presented from the "belgian heart disease prevention project, part of the WHO european collaborative trial in the multifactorial prevention of coronary heart disease (CHD)". 19.409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038); coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5%, (P = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).