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American Journal of Epidemiology Vol. 114, No. 1: 81-94
Copyright © 1981 by The Johns Hopkins University School of Hygiene and Public Health

research-article

CHANGES IN SMOKING, SERUM CHOLESTEROL AND BLOOD PRESSURE LEVELS DURING A COMMUNITY-BASED CARDIOVASCULAR DISEASE PREVENTION PROGRAM—THE NORTH KARELIA PROJECT

JUKKA T. SALONEN1,2,, PEKKA PUSKA1,3, THOMAS E. KOTTKE4 and JAAKKO TUOMILEHTO1

1The North Karelia Project, University of Kuopio Kuopio, Finland
2Research Institute of Public Health, University of Kuopio
3Epidemiological Research Unit, National Public Health Laboratory Helsinki, Finland
4Laboratory of Physiological Hygiene, School of Public Health, University of Minnesota Minneapolis, MN

Reprint requests to Dr. Jukka T. Salonen, University of Kuopio, Box 40, 70101 Kuopio 10, Finland

A comprehensive community-based program to control cardiovascular disease was carried out in North Karelia, Finland, in 1972–1977. Reductions in smoking, serum cholesterol and blood pressure (BP) levels were among the central intermediate objectives. The effect was evaluated by examining independent population samples at the outset and at the end, both in the program area and in a matched reference area. More than 10,000 subjects were studied each time (participation rate about 90%). This paper presents the analyses of the estimated effect of the program on the risk factor means by comparing the baseline and terminal situations among the population aged 30–59 years. The effect of the program among men was estimated to be a reduction of 13% in smoking, 4% in serum cholesterol and 3% in systolic and diastolic BP means. Among women, there was a net reduction of 5% in systolic BP and 4% in diastolic BP means. The net reductions in smoking (8%) and serum cholesterol (1%) among women were within sampling variation. It is concluded that the population means of the major coronary heart disease risk factors were reduced during the program more in the intervention area than in the reference area, and it seems likely that most of this difference was due to the program.

blood pressure; cardiovascular diseases; cholestrol; community health services; evaluation studies; preventive health services; smoking


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