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Twelve-year results of the Coronary Risk Factor Study (CORIS)
K Steyn1, M Steyn, A S Swanepoel
1Chronic Diseases of Lifestyle Program of the Medical Research Council, Tygerberg, RSA.
Insights
Long-term health promotion strategies can reduce cardiovascular disease risk. A low-intensity intervention town maintained better risk profiles 12 years later, suggesting sustained effectiveness of media-based health promotion.
Area of Science:
- Public Health
- Epidemiology
- Health Promotion
Background:
- A 4-year coronary heart disease risk factor intervention program showed significant risk reduction in two intervention towns compared to a control town.
- Intervention effects were assessed post-program cessation, considering community participation and secular trends.
Purpose of the Study:
- To assess the long-term impact of a coronary heart disease risk factor intervention program.
- To evaluate the influence of secular trends on intervention effectiveness.
- To compare risk factor profiles in intervention and control towns after program cessation.
Main Methods:
- Cross-sectional surveys of 1620 participants (aged 15-64) were conducted 12 years post-intervention.
- A subsequent study involved 327 participants (aged 35-44) in control and non-intervention towns.
- Data collected included risk factor knowledge, medical history, blood pressure, anthropometry, and blood lipids.
Main Results:
- The low-intensity intervention town maintained a significantly better risk factor profile 12 years later.
- The high-intensity intervention town's profile matched the control town after 12 years.
- No significant differences in risk factor profiles were observed between the control town and two new towns; however, coronary heart disease and stroke deaths showed a downward trend.
Conclusions:
- Secular trends may have diminished intervention effects in the high-intensity town but not the low-intensity town.
- The low-intensity intervention town demonstrated a sustained advantage over the control town.
- Results support the long-term effectiveness of media-based health promotion for reducing cardiovascular disease risk profiles.
Background:
After 4 years a coronary heart disease risk factor intervention programme produced equally large and significantly reduced risk profiles in two intervention towns compared with a control town. Intervention effects through community participation were assessed after cessation of the active intervention programme. The impact of secular trends was assessed in the control town and in two previously unstudied towns.
Methods:
Cross-sectional surveys were done in a random sample of 1620 participants aged 15-64 years in the three original towns 12 years after the initial quasi-experimental study. Two years later 327 subjects, aged 35-44 years, were studied in the original control town and in two non-intervention towns. Risk factor knowledge, smoking and medical histories were determined by questionnaire. Blood pressure, anthropometry and blood lipids were recorded. Data were compared across towns, and with previous surveys.
Results:
At 12 years the low intensity intervention town maintained a significantly better risk factor profile than the control town, while the high intensity intervention town now matched the control town. No differences in risk factor profiles were found between the control town and the two new towns. Deaths from coronary heart disease and strokes showed a downward trend in the study area.
Conclusions:
Outcome suggests large ongoing secular trends during the study could have overtaken the intervention effects in the high intensity town, but not in the low intensity intervention town, which showed an advantage over the control town. These results support the effectiveness of media-based, long term health promotion strategies to reduce cardiovascular disease risk profiles.
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