Copyright © 1982 by the European Society of Cardiology.
© 1982 by The European Society of Cardiology
Multifactorial trial in the prevention of coronary heart disease: 2. Risk factor changes at two and four years
WORLD HEALTH ORGANIZATION EUROPEAN COLLABORATIVE*World health organization Copenhagen, Denmark
Received 2 November 1981; .
Requests for reprints to: Professor H. Tunstall Pedoe, Cardiovascular Epidemiology Unit, Ninewells Hospital and Medical School, Dundee DDl 9SY, Scotland.
Abstract
The interim risk factor changes at two and four years from onset are described in an international controlled trial of multifactorial prevention of coronary heart disease involving 63 732 men aged 40–59 in 44 pairs of factories in Belgium, Italy, Poland, Spain and the United Kingdom. These show a net reduction, on average, of most factors which was large enough to be worthwhile if reflected in incidence rates, but less than had been hoped for and not completely consistent or sustained. Cholesterol levels failed to fall in some centres at two years but did so at four as the result of more intensive health education. Self-reported cigarette consumption fell more markedly than did the proportion of smokers. Estimates of the risk of a major coronary event at two years fell by 10% in the intervention group overall and by 14% in men judged to be at high risk and given individual attention, whereas at four years the figures were 14% for the group overall and 24% in high risk men. An equivalent fall in incidence might not be demonstrated in a study even of this size. The value of these changes must be interpreted in the light of future pooled incidence results and in relation to the amount of work involved in the intervention programme which was of moderate intensity and could have been greater with some expansion of money and manpower. Country by country differences in results were partly explainable by local circumstances although most of them were within the limits of sampling error.
Key Words: Coronary heart disease • prevention • risk factors • health education • blood pressure control • cigarette smoking • cholesterol
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