The european multifactorial preventive trial of coronary heart disease: four-year experience.

The European Multifactorial Preventive Trial of Coronary Heart Disease operates in five centers in Belgium, Italy, Poland, Spain, and Great Britain with a total of 44 pairs of factories employing over 63,000 men aged 40-59. Pairs of factories were randomly allocated to either treatment or control. An entry screening for risk factors was offered to all men in treatment factories and to random samples of men in control factories. Those identified as relatively high-risk in treatment factories (upper 15-20%) were individually treated with advice for cholesterol lowering diet, smoking cessation, regular exercise, weight reduction, and drug control of hypertension, whereas mass education on the same subjects was given to non-high-risk individuals. Random samples of men were reexamined after 2 and 4 years in order to assess risk factor changes, with control groups serving as reference for naturally occurring trends. Changes of main risk factors recorded in different centers varied considerably. Pooled data showed a net reduction of 2.5% random sample (RS) and 5.8% high-risk (HR) for serum cholesterol; of 1.3% (RS) and 2.6% (HR) for systolic blood pressure; of 0.5% (RS) and 0.9% (HR) for body weight; and 8.8% (RS) and 15.2% (HR) for cigarette consumption. The net reduction of coronary risk estimated by the multiple logistic equation was 12% in RS and 17% in HR.