Journal
CURRENT OPINION IN CARDIOLOGY
Volume 23, Issue 5, Pages 452-461Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HCO.0b013e32830c217e
Keywords
community; heart disease; population; prevention
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Purpose of review The prevalence of coronary heart disease (CHD) risk factors in the population necessitates investment in the design and delivery of effective population-level interventions to prevent and enhance the management of CHD. This review examines the approaches that have been central to the design and delivery of previous, seminal population-level CHD prevention programs; it offers recommendations for the design and evaluation of the next generation of population-level CHD prevention trials. Recent findings Almost 50% of the decline in the rates of CHD mortality in the developed world can be attributed to population-level declines in CHD risk factors, including cholesterol, hypertension, and smoking. There is evidence that community-based CHD prevention interventions can have a positive impact on these risk factors within a distinct population. More recent community-based CHD trials have focused on discrete populations including the socioeconomically deprived, ethnic minorities, and rural communities. Summary There has been large variability in the success experienced by population-level CHD prevention trials. Best practices have emerged which may be used to inform the design of future trials. These include the need for multisectoral partnerships, coordination of multi-level interventions (programs and policy), and delivering a sufficient intervention dose to targeted populations.
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