International Journal of Epidemiology 2001;30:1496-1497
© International Epidemiological Association 2001
Letter to the Editor |
Editors' Response—exporting failure
Our editorial described the limited effects of comprehensive cardiovascular disease prevention programmes, widely evaluated in the developed world, and questioned their relevance to developing countries.1
Dr Puska complains that we have not read the findings of the North Karelia study carefully enough. Interpretation of what is shown by the North Karelia study depends on understanding the nature of the intervention, the time frame over which changes were examined, and whether one is primarily interested in ‘explaining’ the changes observed within North Karelia without reference to other studies examining the same question. The intervention comprised five arms: health education, screening, a hypertension programme, ‘intensification of treatment’ (secondary prevention), and rehabilitation, and as such, was focused mainly on individuals rather than the population at large.2 As shown in Table 1 of our editorial, the reductions in risk factors were, in
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