Can a community based health program lower cardiovascular morbidity?

January 01, 0001

Can a community based health program lower cardiovascular morbidity?

Although many interventions have been showed to have an effect on cardiovascular risk factors, the real question is whether there are clinically significant benefits. These Canadian researchers examined the community based Cardiovascular Health Awareness Program (CHAP) on morbidity from cardiovascular disease via a community cluster randomized trial. Community dwelling geriatric patients (aged 65 and up) at the various sites were randomized to receive CHAP vs no intervention. In CHAP communities, residents were invited to cardiovascular risk assessment and education sessions.

The researchers found: "All 20 intervention communities successfully implemented CHAP. A total of 1265 three hour long sessions were held in 129/145 (89%) pharmacies during the 10 week programme. 15?889 unique participants had a total of 27,358 cardiovascular assessments with the assistance of 577 peer volunteers. After adjustment for hospital admission rates in the year before the intervention, CHAP was associated with a 9% relative reduction in the composite end point (rate ratio 0.91) or 3.02 fewer annual hospital admissions for cardiovascular disease per 1000 people aged 65 and over. Statistically significant reductions favouring the intervention communities were seen in hospital admissions for acute myocardial infarction (rate ratio 0.87) and congestive heart failure (0.90) but not for stroke (0.99)."

The researchers concluded: "A collaborative, multi-pronged, community based health promotion and prevention programme targeted at older adults can reduce cardiovascular morbidity at the population level."

This community-based health education program is shown to have a cardiovascular morbidity benefit when used in community-dwelling geriatric patients.

For the full abstract, click here.

BMJ342:d442, 7 February 2011 © 2011 BMJ Publishing Group Ltd.
Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP). Janusz Kaczorowski, Larry W Chambers, Lisa Dolovich, et al. Correspondence to J Kaczorowski: [email protected]

Category: K. Circulatory. Keywords: cardiovascular risk, cardiovascular risk, community-based, education, prevention, randomized trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 25 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.