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[Risk factor changes in four years in the Rome Project of Coronary Heart Disease Prevention (PPCC) (AUTHOR'S TRANSL)]
Insights
The Rome Project of Coronary Heart Disease Prevention trial significantly reduced risk factors like blood pressure and cholesterol in middle-aged men. This intervention led to a notable decrease in the theoretical risk of coronary heart disease.
Area of Science:
- Cardiovascular disease prevention
- Public health interventions
- Clinical trials
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality globally.
- Primary multifactorial prevention trials are crucial for reducing CHD incidence.
- The Rome Project of Coronary Heart Disease Prevention (PPCC) is the Italian arm of a major European CHD prevention initiative.
Purpose of the Study:
- To evaluate the effectiveness of a multifactorial intervention in reducing CHD risk factors.
- To assess the impact of the intervention on theoretical CHD risk over five years.
Main Methods:
- A randomized controlled trial involving 6,000 men aged 40-59.
- Intervention group received tailored health education and individual counseling for high-risk individuals (top 30%).
- Control group received no intervention; data collected over four years.
Main Results:
- Significant reductions in body weight, systolic and diastolic blood pressure, and serum cholesterol in the intervention group compared to controls.
- A significant decrease in daily cigarette consumption was observed in high-risk subgroups only.
- Serum triglycerides showed no significant decrease in either subgroup.
- A 39% net reduction in theoretical five-year CHD risk was estimated for high-risk intervention subgroups.
- A 31% net reduction in theoretical five-year CHD risk was estimated for the overall intervention population.
Conclusions:
- Multifactorial interventions can effectively reduce key CHD risk factors in middle-aged men.
- The PPCC trial demonstrated a significant reduction in theoretical CHD risk, supporting the efficacy of the implemented preventive strategies.
- Targeted interventions combined with mass health education show promise for large-scale CHD prevention efforts.
Abstract:
The Rome Project of Coronary Heart Disease Prevention (PPCC) is a primary multifactorial preventive trial of CHD representing the Italian section of the WHO European Multifactor Preventive Trial of CHD. It operates on 6,000 men aged 40--59 at entry enrolled in occupational groups and randomly divided into treated and controls. The intervention, directed to modify the levels of some risk factors is individually-oriented in subjects belonging to the upper 30% of a risk score computed in the treatment groups, is based on mass health education in the remaining 70% of treatment groups, while no treatment is provided by the Research Group to the controls. Four years after the start of the trial, the levels out of certain risk factors considered in this analysis (body weight, systolic and diastolic blood pressure, serum cholesterol) showed, in the treatment groups, a significant decreasing trend as compared to those observed in control groups, both considering the subgroup at relatively high risk and the random one representing the whole populations. Daily cigarette consumption significantly decreased in high risk subgroups but none in random ones, while serum triglycerides did not decrease in either subgroups. The estimated theoretical risk of CHD in five years computed by multiple logistic function showed a 39% net reduction in treatment high risk subgroups and a 31% net reduction in the whole treatment populations.