title: Residual beneficial effects after a 3-year integrated intervention on stroke in China:  a 10-year prospective follow-up.
abstract: OBJECTIVE
  To evaluate whether an intervention program designed to reduce stroke incidence would have long-term residual effects on reducing all-cause and cause-specific mortalities, including cancer 10 years after the intervention was completed.
  
  
  METHODS
  This is a posttrial analysis. We prospectively observed the mortality of a community-based trial of primary prevention of stroke in China performed between July 1987 and June 1990 by extending the follow-up to 30 June 2000. At the baseline, 26,607 adults aged 35 years or above and free from stroke were recruited from five cites of mainland China; 13,212 and 13,395 were assigned into intervention and control group, respectively. Participants in intervention group received a regularly integrated intervention including lifestyle intervention and hypertensive drug treatment. The controls did not receive intervention provided by the investigators.
  
  
  RESULTS
  During the 10-year posttrial follow-up period, we observed a significant reduction on overall deaths [hazard ratio 0.91; 95% confidence interval (CI) 0.83, 0.99] and stroke mortality (hazard ratio 0.79; 95% CI 0.63, 1.00). An insignificant late trial beneficial effect was observed for hypertensive disease (hazard ratio 0.69; 95% CI 0.30, 1.58), ischemic heart disease (hazard ratio 0.87; 95% CI 0.64, 1.17), other nonmalignant diseases, and most cancer sites.
  
  
  CONCLUSIONS
  This study demonstrates that a 3-year integrated intervention program successful for stroke prevention had long-term residual beneficial effects on reducing overall disease burdens among urban Chinese population, especially for the deaths from stroke. However, whether the integrated intervention also leads to reduced mortality of cardiovascular diseases and cancer would have to be confirmed by future larger studies.
authors: School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
authors: Lap-Ah
authors: LA
authors: Tse
authors: Xiang-Hua
authors: XH
authors: Fang
authors: Ignatius Tak-Sun
authors: IT
authors: Yu
authors: Hong
authors: H
authors: Qiu
authors: Wen-Zhi
authors: WZ
authors: Wang
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020521:Stroke / Q000628:therapy*; D016896:Treatment Outcome; D014505:Urban Population