Ten years of the North Karelia project

Medical and epidemiological research into the aetiology of CHD has drawn attention to the likely causal role of certain risk factors, especially elevated serum (LDL) cholesterol and blood pressure levels, and smoking. Conventional trials to establish the causality have come up against problems of feasibility and study design. Community-based studies have considerable potential in introducing changes to the general lifestyle and risk factors in large numbers of people (since the risk factors are closely related to the way of life and other features of the community). Thus a well evaluated community-based study can augment our knowledge on the role of the risk factors. Furthermore, a community study examines how the existing service structure and community resources can be used and assesses the overall feasibility and consequences of such an intervention. The North Karelia project, started in eastern Finland in 1972, has been a major community-based study on the prevention of CHD. The results of the 10-year evaluation of the project illustrate the feasibility and consequences of the approach. During the 10-year period 1972-82 the following net changes (i.e. adjusted for changes in the reference area) occurred in the risk factor means of the population aged 30-59 in North-Karelia: -28% for smoking (p less than .001), -3% for serum cholesterol (p less than .001) and -3% for systolic BP (p less than .001). During the period 1974-79 the age-standardized CHD mortality of men aged 30-64 was reduced by 22% in North Karelia, 12% in the reference area and 11% in the rest of Finland (p less than .05 compared with NK).(ABSTRACT TRUNCATED AT 250 WORDS)