The North Karelia community-based prevention program reduced coronary mortality in the middle-aged population by 84% from 1972 to 2014 through lifestyle changes and improved treatments.
Does a comprehensive community-based prevention program reduce cardiovascular risk factors and coronary mortality in a high-risk population?
A comprehensive community-based prevention program targeting lifestyle and environmental changes led to an 84% reduction in coronary mortality over 40 years, primarily driven by risk factor improvements.
Effect estimate: 84% reduction
The extremely high cardiovascular mortality in an eastern province North Karelia in Finland caused great concern among the local population. Action to reduce the problem was demanded in a petition to the Finnish government signed by local representatives of the population. In response, the North Karelia project was launched in 1972 to carry out a comprehensive community based prevention program. After the first five years, prevention activities were also started nationally. The main aim was to reduce the extremely high serum cholesterol, blood pressure and smoking levels with lifestyle changes and improved drug treatment, especially for hypertension. Major declines were seen in serum cholesterol, blood pressure and smoking levels. Coronary mortality reduced in middle age population by 84% from 1972 to 2014. About 2/3 of the mortality decline was explained by risk factor changes and 1/3 by improvement of new treatments developed since 1980s. Population-based prevention through changes in lifestyle and environment is the most cost effective and sustainable way of controlling cardiovascular and other major non-communicable diseases. In the current global situation it is a powerful lesson.
Erkki Vartiainen (Mon,) conducted a review in Cardiovascular disease. North Karelia Project (community-based prevention program) vs. Historical baseline and reference province (Kuopio) was evaluated on Coronary mortality in middle-aged population (84% reduction). The North Karelia community-based prevention program reduced coronary mortality in the middle-aged population by 84% from 1972 to 2014 through lifestyle changes and improved treatments.