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The european multifactorial preventive trial of coronary heart disease: four-year experience
Insights
This trial reduced coronary heart disease risk factors in middle-aged men through lifestyle advice. High-risk men showed greater improvements in cholesterol, blood pressure, weight, and smoking cessation.
Area of Science:
- Cardiovascular Disease Prevention
- Public Health Interventions
- Occupational Health
Background:
- Coronary heart disease (CHD) poses a significant public health challenge.
- Multifactorial preventive strategies targeting major risk factors are crucial.
- Workplace settings offer opportunities for large-scale health interventions.
Purpose of the Study:
- To evaluate the effectiveness of a multifactorial preventive intervention for CHD in male factory workers.
- To assess the impact of lifestyle modifications on major CHD risk factors.
- To compare intervention effects between high-risk and general populations.
Main Methods:
- The European Multifactorial Preventive Trial involved 44 pairs of factories across five countries.
- Men aged 40-59 were screened for risk factors; high-risk individuals (15-20%) received intensive advice.
- Interventions included diet, smoking cessation, exercise, weight reduction, and hypertension management; mass education for others.
- Follow-up assessments at 2 and 4 years monitored risk factor changes against control groups.
Main Results:
- Pooled data revealed significant reductions in serum cholesterol, systolic blood pressure, body weight, and cigarette consumption.
- High-risk men demonstrated greater risk factor reductions compared to random samples.
- Net reduction in coronary risk was estimated at 12% for random samples and 17% for high-risk individuals.
Conclusions:
- A multifactorial preventive approach targeting lifestyle factors is effective in reducing CHD risk in middle-aged men.
- Intensive interventions for high-risk individuals yield more substantial improvements.
- Workplace-based trials can successfully implement and evaluate large-scale cardiovascular health promotion programs.
Abstract:
The European Multifactorial Preventive Trial of Coronary Heart Disease operates in five centers in Belgium, Italy, Poland, Spain, and Great Britain with a total of 44 pairs of factories employing over 63,000 men aged 40-59. Pairs of factories were randomly allocated to either treatment or control. An entry screening for risk factors was offered to all men in treatment factories and to random samples of men in control factories. Those identified as relatively high-risk in treatment factories (upper 15-20%) were individually treated with advice for cholesterol lowering diet, smoking cessation, regular exercise, weight reduction, and drug control of hypertension, whereas mass education on the same subjects was given to non-high-risk individuals. Random samples of men were reexamined after 2 and 4 years in order to assess risk factor changes, with control groups serving as reference for naturally occurring trends. Changes of main risk factors recorded in different centers varied considerably. Pooled data showed a net reduction of 2.5% random sample (RS) and 5.8% high-risk (HR) for serum cholesterol; of 1.3% (RS) and 2.6% (HR) for systolic blood pressure; of 0.5% (RS) and 0.9% (HR) for body weight; and 8.8% (RS) and 15.2% (HR) for cigarette consumption. The net reduction of coronary risk estimated by the multiple logistic equation was 12% in RS and 17% in HR.