Evaluation of a community program for the control of cardiovascular risk factors: the CHAD program in Jerusalem

A community-focused program for the control of cardiovascular risk factors, the CHAD program, was instituted in a family practice in western Jerusalem in 1971. Its effectiveness was evaluated by comparing the changes detected by surveys conducted in 1970 and 1975 with those observed in an adjacent control neighborhood. Hypertension decreased in prevalence by 33%, hypercholesterolemia by 31%, cigarette smoking by 23% (among men), and overweight by 13%. Allowing for the reductions observed in the control population, the net percent reductions in prevalence were 20% for hypertension, 15% for hypercholesterolemia, 11% for cigarette smoking (men) and 13% for overweight. The net reductions in hypertension, smoking and overweight were statistically significant. The net reductions in mean systolic and diastolic pressures and weight were also significant. The results suggest that intervention centered in primary health care can have an appreciable effect on cardiovascular risk factors in the population.