Reduction of cardiovascular risk and mortality: a population-based approach.
The purpose of this study was to evaluate risk pattern and mortality in a general population epidemiologic study performed by a staff of hypertension specialists working as the "good father of a family," with lifestyle and therapeutic advice and instrumental measurements. Mortality among the study population (n=856) during the 4-y study was compared with that recorded in the general population during the 4-y period before the study; those who refused to participate in the study were also recorded (n=280). Among study subjects, blood pressure decreased by 3.6/3.5 mm Hg (P<.01/P<.0001), serum total cholesterol by 3.8% (P<.0001), and low-density lipoprotein cholesterol by 10.9% (P<.01); awareness of hypertension increased by 87% (P<.0001); 20% of hypercholesterolemic patients (P<.01) and 28% of diabetic patients (P<.001) were identified; and 40% of hypertensive patients (P<.0001) were treated. Overall 4-y mortality was 12.5% in study subjects, 36.6% in renitent subjects (P<.0001 vs enrolled), and 19.9% during the period preceding the study (P<.0001 vs enrolled); cardiovascular mortality rates were 5.8%, 18.6% (P<.0001), and 11.4% (P<.0001), respectively. In particular, the frequency of fatal stroke was 0.06%, 3.8% (P<.0001), and 2.5% (P<.0001), respectively, and that of fatal coronary events was 3.4%, 7.5% (P<.0001), and 4.6% (P<.0001), respectively. In conclusion, when an epidemiologic professional staff member approaches patients in a manner similar to that of the "good father of a family," a better risk pattern and lower mortality rates (particularly cerebrovascular and coronary) are seen in those who are receptive to the care provided; those who decide not to participate in health care opportunities do not benefit.
Casiglia
Edoardo
E
Department of Clinical and Experimental Medicine, University of Padova, Italy.
Saugo
Mario
M
Schiavon
Laura
L
Tikhonoff
Valérie
V
Rigoni
Giulio
G
Basso
Giancarlo
G
Mazza
Alberto
A
Rizzato
Enzo
E
Guglielmi
Francesco
F
Martini
Bortolo
B
Bascelli
Anna
A
Caffi
Sandro
S
Pessina
Achille C
AC
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D016021:Epidemiologic Studies; D005260:Female; D006266:Health Education; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D012307:Risk Factors