Evaluating the Effects of Community Intervention for Risk Factors of Cardiovascular Disease

Abstract

In the late sixties almost unanimous scientific agreement was achieved with regard to the important role, some then so-called risk factors play in the prediction of cardiovascular and especially of coronary heart disease (1). “Primary risk factors” — cigarette smoking, total cholesterol and systolic resp. diastolic blood pressure — might be differentiated from “secondary factors” like impaired glucose tolerance, obesity or type A-behaviour, where the position in a chain of events leading to circulatory complications is less clear. It is evident, however, that the predictive power of a risk variable like blood pressure for e.g. stroke does not necessarily correspond to the interventive potential of reducing elevated blood pressures, i.e. normalization of high blood pressure values is not in itself identical with the reduction of stroke mortality resp. stroke morbidity, due at least in part to a limited reversibility of the arterioclerotic process in the vessel wall. This is the rationale for testing the effectiveness of intervention in unselected, still more or less healthy populations.