title: Impact of health counselling on cardiovascular disease risk in middle aged men: influence of socioeconomic status.
abstract: BACKGROUND
  The inverse association between socioeconomic status and cardiovascular disease is well documented. We examined whether the impact of health counselling on cardiovascular risk factors in middle-aged men differed according to socioeconomic status.
  
  
  METHODS
  We used data from a community based study assessing the risk for cardiovascular disease among middle-aged men in Helsinki, Finland. Traditional cardiovascular disease risk factors were measured and cardiovascular disease risk was assessed by a modified risk tool used in the North Karelia project (CVD Risk Score). Those men with increased risk for cardiovascular disease at their baseline visit in 2006 received lifestyle counselling. After two years these high-risk men were invited to a follow-up visit. The same measurements and risk assessments were repeated.
  
  
  RESULTS
  Based on the CVD Risk Score there were significant differences between the groups at baseline (p = 0.001) and at follow-up (p<0.001) with the highest scores in the lowest educational group. There were no significant differences in traditional cardiovascular risk factors according to educational attainment between groups either at baseline or at follow-up. Baseline lifestyle characteristics differed between the groups regarding use of soft fat (p = 0.019). All groups responded positively to lifestyle counselling.
  
  
  CONCLUSIONS
  The present study showed that lifestyle counselling is feasible in high-risk middle-aged men and lifestyle intervention works in all educational groups. Interestingly the traditional risk factors did not show improvement, but the risk score improved. From a practical point of view our findings stress the importance of using risk score calculators in health counselling instead of looking at individual cardiovascular disease risk factors.
authors.affiliation: Health Centre of City of Helsinki, Helsinki, Finland ; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
authors.forename: Reijo
authors.initials: R
authors.lastname: Siren
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland ; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland ; Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland ; Folkhalsan Research Centre, Helsinki, Finland.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Peltonen
authors.affiliation: The Social Insurance Institution of Finland (KELA), Helsinki, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Vanhanen
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003376:Counseling; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006262:Health; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class