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Belgian heart disease prevention project: incidence and mortality results
Insights
This study found that a workplace intervention significantly reduced total mortality by 17.5% in men aged 40-59. The program focused on diet, smoking cessation, and blood pressure management, lowering coronary heart disease risk factors.
Area of Science:
- Cardiovascular Disease Prevention
- Public Health Interventions
- Epidemiology
Background:
- Coronary Heart Disease (CHD) poses a significant public health challenge globally.
- Multifactorial prevention strategies are crucial for mitigating CHD risk.
- Workplace interventions offer a viable setting for large-scale health promotion.
Purpose of the Study:
- To evaluate the effectiveness of a multifactorial intervention in preventing coronary heart disease.
- To assess the impact of workplace-based health education and counseling on CHD risk factors and outcomes.
- To analyze the effects on total mortality, coronary mortality, and CHD incidence.
Main Methods:
- A randomized controlled trial involving 19,409 men aged 40-59 across 30 factories.
- Intervention group received health education on diet, smoking cessation, weight control, physical activity, and hypertension management.
- Face-to-face counseling supplemented the information program over a 5-6 year period.
Main Results:
- Significant reductions in serum cholesterol, daily cigarette consumption, and arterial blood pressure in the intervention group.
- Total mortality was 17.5% lower in the intervention group (p = 0.038).
- Coronary Heart Disease incidence decreased by 24.5% (p = 0.031), with non-fatal myocardial infarction reduced by 26.1% (p = 0.030).
Conclusions:
- Workplace-based multifactorial interventions can effectively reduce coronary risk profiles.
- This intervention led to a significant reduction in total mortality and CHD incidence.
- Health education and counseling programs in occupational settings are valuable for cardiovascular disease prevention.
Abstract:
Results 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).