Abstract 11878: Forty-Year Change in Coronary Heart Disease Mortality Among Working Aged Men and Women in Eastern Finland: The Role of Primary Prevention and Risk Factor Reduction
Introduction: In the late 1960s, Eastern Finland had the highest CHD mortality in the world. Community-based CVD prevention program - the North Karelia Project - was launched in 1972. This study aims to estimate the extent to which changes in the main CVD risk factors explain the decline in CHD mortality among working aged population in Eastern Finland.
Methods: Predicted change in CHD mortality was estimated by a logistic regression model using risk factor data of 37,177 men and women aged 30-59 years who participated in CVD risk factor surveys conducted every five years since 1972. The latest FINRISK survey was done in 2012. Data on observed CHD mortality were obtained from the National Causes of Death Register. The register includes all deaths among Finnish citizens and the data is practically complete.
Results: From early seventies (1969-1972) to 2012 CHD mortality decreased among men aged 35 to 64 years by 82% (from 643 to 118 per 100,000). Among women the decrease was 84% (from 114 to 17 per 100,000). During the same time period, the levels of major CVD risk factors, smoking prevalence, serum total cholesterol and blood pressure decline remarkably, except a small increase in serum cholesterol and diastolic blood pressure levels between 2007 and 2012. During the first ten years, changes in major risk factors explained nearly all of the observed mortality reduction (table). Since mid-1980s, observed reduction in mortality has been larger than predicted. In the last ten years about two thirds of the CHD mortality reduction was explained by changes in classical risk factors and one third by other factors, including secondary prevention and treatment of acute CHD events.
Conclusion: Population based primary prevention and reduction in the levels of major risk factors are crucial in lowering of disease burden and mortality due to CHD. An additional gain can be achieved by secondary prevention among high risk individuals and by treatment of acute events.
Author Disclosures: P. Jousilahti: None. T. Laatikainen: None. M. Peltonen: None. K. Borodulin: None. S. Männistö: None. A. Jula: None. V. Salomaa: None. P. Puska: None. E. Vartiainen: None.
- © 2014 by American Heart Association, Inc.