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Favourable long-term effects of a cardiovascular prevention program in primary health care in Sweden in men, and women on first cardiovascular events, cardiovascular mortality, and all-cause mortality

Session Best Posters 5

Speaker Gunilla Journath

Event : ESC Congress 2018

  • Topic : preventive cardiology
  • Sub-topic : Epidemiology
  • Session type : Best ePosters

Authors : G Journath (Stockholm,SE), N Hammar (Stockholm,SE), N Hammar (Mölndal,SE), M Vikstrom (Stockholm,SE), A Linnersjo (Stockholm,SE), A Linnersjo (Stockholm,SE), G Walldius (Stockholm,SE), I Krakau (Stockholm,SE), P Lindgren (Stockholm,SE), P Lindgren (Stockholm,SE), U De Faire (Stockholm,SE), ML Hellenius (Stockholm,SE)

G. Journath1 , N. Hammar2 , N. Hammar3 , M. Vikstrom4 , A. Linnersjo5 , A. Linnersjo6 , G. Walldius2 , I. Krakau7 , P. Lindgren8 , P. Lindgren9 , U. De Faire4 , M.L. Hellenius1 , 1Karolinska Institute, Department of Medicine, Cardiology Unit - Stockholm - Sweden , 2Karolinska Institute, Division of Epidemiology, Institute of Environmental Medicine - Stockholm - Sweden , 3AstraZeneca R&D - Mölndal - Sweden , 4Karolinska Institute, Divison of Cardiovascular Epidemiology, Institute of Environmental Medicine - Stockholm - Sweden , 5Stockholm County Council, Centre for Occupational, and Environmental Medicine - Stockholm - Sweden , 6Karolinska Institute, Unit of Occupational Medicine, Institute of Environmental Medicine - Stockholm - Sweden , 7Karolinska Institute, Department of Medicine, Unit of Clinical Epidemiology - Stockholm - Sweden , 8Karolinska Institute, Department of Learning, Information, Management & Ethics - Stockholm - Sweden , 9The Swedish Institute for Health Economics - Stockholm - Sweden ,

Risk Factors and Prevention – Epidemiology

European Heart Journal ( 2018 ) 39 ( Supplement ), 879

Background: Few long-term follow-up studies of cardiovascular disease (CVD) prevention programs have been performed using individual follow-up data on morbidity, and mortality in men and women in primary health.

Objective: To conduct a long-term follow-up of first CVD event (acute myocardial infarction, stroke, or CVD death), CVD death, and all-cause death in men and women following a prevention program focusing on life-style.

Methods: Men, and women who visited the primary health care centres in Sollentuna, a municipality in Stockholm County (N=51 586), during the period August 1988 to December 1993, were invited to participate in a CVD prevention program. Those with at least one CVD risk factor or more, an age ≥15 years, no prior CVD were included in the intervention group (3674 women, and 2087 men), and received individual life-style counselling. The mean age was 45.2 years (SD 13.7) in women, and 46.2 years (SD 14.2) in men. The reference group (21824 women, and 12 742 men) originated from the general population in Stockholm County except Sollentuna during the same period. Propensity score matching was used in order to get similar baseline characteristics in the reference group as in the intervention group. All subjects were followed-up in the National Patient-, and Cause of Death Register in Sweden until December 31, 2011. The study was registered in (NCT 02212145).

Results: The risk of first CVD event, CVD death, and all-cause death were lower in the female intervention group compared with a female reference group with a hazard ratio (HR) of 0.85 (95% CI, (0.76–0.95), HR of 0.79 (95% CI, 0.67–0.94), and HR 0.84 (95% CI, 0.77–0.92) respectively. In the male intervention group compared with the male reference group there were also a lower risk of CVD event HR 0.90 (95% CI, 0.81–1.01), CVD death HR 0.79 (95% CI, 0.67–0.94), and all-cause death HR 0.83 (0.75–0.92). The median follow-up was 22 years (interquarterly range 19–23).

Conclusions: These data imply favourable long-term effects on CVD death, and all-cause death from a primary health care prevention program focusing on men, and women at increased risk. The results underline the importance and usefulness of the primary health care as mediators of life style messages to large segments of the general public.

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