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[比利时心血管疾病预防项目:多因素预防模式]

[The Belgian project for the prevention of cardiovascular diseases: a model of multifactorial prevention].

作者信息

Kornitzer M

出版信息

Bull Mem Acad R Med Belg. 1989;144(1-2):101-9; discussion 110-2.

PMID:2679938
Abstract

Résults are presented from the "belgian heart disease prevention project, part of the WHO european collaborative trial in the multifactorial prevention of coronary heart disease (CHD)". 19.409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038); coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5%, (P = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).

摘要

研究结果来自“比利时心脏病预防项目”,该项目是世界卫生组织在冠心病多因素预防方面开展的欧洲协作试验的一部分。19409名年龄在40至59岁之间的男性参与其中;他们受雇于30家工厂,这些工厂构成了一项为期5至6年的随机对照试验的分配单位。干预措施主要包括促进降低胆固醇饮食、戒烟、控制体重、体育活动以及治疗动脉高血压的健康教育。在项目配备的两名医生在工作场所进行面对面咨询的补充下,开展了一个信息项目。与对照组相比,干预组的冠心病风险状况有所降低,尤其是在最初4年,这是通过对血清胆固醇、每日吸烟量和动脉血压的影响实现的。干预组的总死亡率比对照组低17.5%(p = 0.038);冠心病死亡率降低了20.8%,但未达到显著水平,而冠心病发病率(非致命性心肌梗死加致命性心肌梗死加猝死)降低了24.5%(P = 0.031)。非致命性心肌梗死(并非主要终点)同样降低了26.1%(p = 0.030)。

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