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. [ABSTRACT FROM AUTHOR]