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December 1, 1996American Journal of Public Health107 citationsOpen Access

The long-term effects of a cardiovascular disease prevention trial: the Stanford Five-City Project.

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MWMarilyn A. WinklebyCTC. Barr TaylorDJDarius E. Jatulis

Key Result

A community-based health-education intervention maintained improvements in blood pressure and mortality risk scores at 9 years, though net differences in risk factors were modest.

Key Points

  • This study aims to evaluate the lasting impacts of a preventive health-education intervention on cardiovascular disease risk factors.
  • Conducted surveys in two treatment and two control cities in California at baseline (1979/1980), after 6-year intervention (1985/1986), and follow-up (1989/1990).
  • Evaluated changes in cardiovascular risk-factor differences between treatment and control groups among adults aged 25 to 74.
  • Blood pressure improvements were consistent in treatment cities compared to control cities during follow-up.
  • Cholesterol levels continued to decline in all cities during the follow-up period.
  • Coronary heart disease and all-cause mortality risks improved in treatment cities while leveling out in control cities.

Structured PICO

Does a 6-year community-based health-education intervention improve cardiovascular risk factors in women and men 25 to 74 years of age?

P
Population
Women and men aged 25 to 74 years in four California cities, assessed at baseline, after a 6-year health-education intervention, and at 3-year follow-up.
I
Intervention
6-year community-based health-education intervention
C
Comparator
Control cities receiving no specific intervention
O
Outcome
Net treatment/control differences in risk-factor change (blood pressure, cholesterol, smoking rates, coronary heart disease and all-cause mortality risk scores) at 9 years (6-year intervention + 3 years follow-up)surrogate

A 6-year community-based health education intervention demonstrated sustained but modest improvements in blood pressure and mortality risk scores at 9-year follow-up.

Limitations

  • Modest net differences in risk factors suggest the need for new designs and interventions that will accelerate positive risk-factor change.
  • Modest net differences in risk factors

Abstract

OBJECTIVES: This study examined long-term effects of a health-education intervention trial to reduce the risk of cardiovascular disease. METHODS: Surveys were conducted in California in two treatment and two control cities at baseline (1979/1980), after the 6-year intervention (1985/1986), and 3 years later at follow-up (1989/1990). Net treatment/control differences in risk-factor change were assessed for women and men 25 to 74 years of age. RESULTS: Blood pressure improvements observed in all cities from baseline to the end of the intervention were maintained during the follow-up in treatment but not control cities. Cholesterol levels continued to decline in all cities during follow-up. Smoking rates leveled out or increased slightly in treatment cities and continued to decline in control cities but did not yield significant net differences. Both coronary heart disease and all-cause mortality risk scores were maintained or continued to improve in treatment cities while leveling out or rebounding in control cities. CONCLUSIONS: These findings suggest that community-based cardiovascular disease prevention trials can have sustained effects. However, the modest net differences in risk factors suggest the need for new designs and interventions that will accelerate positive risk-factor change.

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Cite This Study

Winkleby et al. (1996) studied Cardiovascular disease. Health-education intervention vs. Control cities was evaluated on Net treatment/control differences in risk-factor change. A community-based health-education intervention maintained improvements in blood pressure and mortality risk scores at 9 years, though net differences in risk factors were modest.

synapsesocial.com/papers/6a207f52b9ae31350fa5e087https://doi.org/10.2105/ajph.86.12.1773
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