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European Heart Journal 2000 21(19):1591-1597; doi:10.1053/euhj.1999.2037
Copyright © 2000 by the European Society of Cardiology.
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Effectiveness of a decentralized, community-related approach to reduce cardiovascular disease risk factor levels in Germany

W Scheuermanna,f1, O Razumb, R Scheidta, A Wiesemannc, H von Frankenbergd, G Topfe and E Nüsself

a Abteilung Klinische Sozialmedizin, Klinikum der Universität Heidelberg, Heidelberg, Germany
b Abteilung Tropenhygiene und öffentliches Gesundheitswesen, Klinikum der Universität Heidelberg, Heidelberg, Germany
c Lehrbeauftragter für Allgemeinmedizin der Universität Heidelberg, Östringen, Germany
d Facharzt für Innere Medizin, Karlsruhe, Germany
e Facharzt für Innere Medizin, Ansbach, Germany
f Wissenschaftliches Institut der Praxisärzte, Heidelberg, Germany

revised December 13, 1999; accepted December 15, 1999

Abstract

Aims Conventional community-oriented prevention programmes have been moderately successful in reducing cardiovascular disease risk factor levels in the population. Within the German Cardiovascular Prevention Study, a new decentralized and community-related form of preventive intervention was tested.

Methods and Results Interested lay people and general practitioners co-operated in developing activities conducive towards a healthier lifestyle in two towns. Changes in risk factor levels were evaluated by repeated surveys of independent cross-sectional samples in two intervention communities (n=3460, baseline; 2561, final). National survey data (n=4788, baseline; 5311, final) were used to describe secular trends. Six years after the onset of intervention activities the following changes in risk factor prevalence for both sexes combined were observed in the intervention communities (95% CI in brackets): smoking –10·5% (–17·6 to –3·4); hypertension –29·0% (–38·1 to –19·9); total cholesterol ≥250mg.dl–1–8·1% (–15·4 to –0·9). In contrast to a national increase in the prevalence of obesity, this rate remained stable in the intervention communities.

Conclusion Initiating preventive activities developed by community members under the responsibility of local doctors is effective in lowering cardiovascular risk factors at community level. Unlike traditional intervention programmes this new approach does not require external funding and guidance.

Key Words: Cardiovascular disease, health promotion, disease prevention, community medicine, Germany

f1 Correspondence: W. Scheuermann, Abteilung Klinische Sozialmedizin, Klinikum der Universität Heidelberg, Bergheimer Str. 58, 69115 Heidelberg, Germany.

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