International Journal of Epidemiology, Vol 26, 964-971, Copyright © 1997 by International Epidemiological Association
K Steyn, M Steyn, AS Swanepoel, PC Jordaan, PL Jooste, JM Fourie and JE Rossouw
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.
ARTICLES
Twelve-year results of the Coronary Risk Factor Study (CORIS)
Chronic Diseases of Lifestyle Program of the Medical Research Council, Tygerberg, RSA.
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