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March 1, 2016BMJOpen Access

Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study

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Why the study?

Do changes in main cardiovascular risk factors through population-based primary prevention reduce coronary heart disease mortality in working-aged men and women?

Population

34,525 men and women aged 30-59 years who participated in the national FINRISK studies between 1972 and 2012…

Design

Cohort

Follow-up

40 years

Key result

Population-based primary prevention reducing three major risk factors explained 69% (men) and 66% (women) of the 82% and 84% respective reductions in coronary heart disease mortality over 40 years.

Authors

PJPekka JousilahtiTLTiina LaatikainenMPMarkku Peltonen

Discussion

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Overview

Supports targeting smoking, cholesterol, and BP in primary prevention; leaves open contributions of other factors in observational data.

Key Points

  • To estimate how much long-term population-level changes in smoking, cholesterol, and blood pressure contributed to falling coronary heart disease mortality over 40 years.
  • Conducted a population-based observational study of 34,525 men and women aged 30–59 years across nine consecutive national surveys in eastern Finland between 1972 and 2012.
  • Applied logistic regression modeling to survey risk factor data to estimate predicted age-standardized coronary heart disease mortality and compared projections against the National Causes of Death Register.
  • Observed age-standardized coronary heart disease mortality fell by 82% (from 643 to 118 deaths per 100,000) in men and by 84% (from 114 to 17 deaths per 100,000) in women aged 35–64 years between 1969–1972 and 2012.
  • Reductions in smoking prevalence, systolic blood pressure, and cholesterol explained nearly all mortality reductions in the first decade and roughly two thirds of the decline (69% in men, 66% in women) in the final decade.

Study Design

Type

Observational (n=34,525)

Structured PICO

Do changes in main cardiovascular risk factors through population-based primary prevention reduce coronary heart disease mortality in working-aged men and women?

P
Population
34,525 men and women aged 30-59 years who participated in the national FINRISK studies between 1972 and 2012 in eastern Finland.
I
Intervention
Change in main cardiovascular risk factors (smoking prevalence, serum cholesterol, and systolic blood pressure) through population based primary prevention.
O
Outcome
Predicted and observed age standardised mortality due to coronary heart disease.hard clinical

Population-based primary prevention programs targeting smoking, cholesterol, and blood pressure can achieve substantial reductions in coronary heart disease mortality.

Cite This Study

Jousilahti et al. (2016) conducted an observational in Coronary heart disease (n=34,525). Population based primary prevention (change in main cardiovascular risk factors) was evaluated on Predicted and observed age standardised mortality due to coronary heart disease. Population-based primary prevention reducing three major risk factors explained 69% (men) and 66% (women) of the 82% and 84% respective reductions in coronary heart disease mortality over 40 years.

synapsesocial.com/papers/6a1698f7798df06fa4b25424https://doi.org/10.1136/bmj.i721
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