P608Comparison of trends in cardiovascular risk factors between two regions with and without a community and primary care prevention programme

Abstract

Background: The effect of interventions for the primary prevention of cardiovascular disease (CVD) based either in primary health care or in the community is debated due to lack of evidence. The XX Intervention Programme is an individual and community‐based public health programme that comprises the whole county of XX. Some residents, 40, 50 and 60 years of age, are invited to a standardised health examination and a health dialogue at their local primary health care centre. In the neighbouring county YY, no such programs have been implemented. We aimed to analyse if trends in CVD risk factors in the intervention area differed from those in the control area. Method: Between 1994 and 2014, five surveys were performed in the XX and YY counties on randomly selected persons aged 40 to 75 years, and altogether 6600 subjects participated (75.4% of those invited). We compared time trends in risk factors between the two counties using regression models including age, county, and year of survey. To test if time trends differed between counties, the interaction between county and year was included in the models. Results: Systolic blood pressure declined in both counties, and the decline was faster in XX than in YY (p=0.043 for interaction county∗year). Diastolic blood pressure declined in XX but increased in YY (p<0.001). Cholesterol levels declined at a similar rate in both counties whereas body mass index (BMI) increased in both counties. The trend in waist circumference or the proportion of participants with BMI >25 or BMI>30 did not differ between the counties. Hip circumference decreased at a similar rate in both counties. Fasting glucose decreased in XX (p=0.003) and increased in YY whereas trends in the prevalence of known diabetes did not differ. The prevalence of regular smokers decreased faster in XX than in YY (p=0.01). Having an academic degree increased over time in both counties and at a similar rate. Physical inactivity decreased at the end of the period but at a similar rate in both counties. Conclusion: Blood pressure, glucose and smoking improved at a faster rate in the county with a community and primary care‐based intervention than in the county without such an intervention.