Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | European Journal of Cardiovascular Prevention & Rehabilitation |
| Vol/bind | 16 |
| Udgave nummer | 5 |
| Sider (fra-til) | 541-9 |
| Antal sider | 8 |
| ISSN | 1741-8267 |
| DOI | |
| Status | Udgivet - 2009 |
Bibliografisk note
Keywords: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Aspirin; Biological Markers; Blood Pressure; Cardiovascular Diseases; Cholesterol; Cohort Studies; Europe; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Mass Screening; Middle Aged; Patient Compliance; Population Surveillance; Preventive Health Services; Risk Assessment; Risk Factors; Risk Reduction Behavior; Smoking; Smoking Cessation; Time Factors; Treatment Outcome; Young AdultAdgang til dokumentet
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I: European Journal of Cardiovascular Prevention & Rehabilitation, Bind 16, Nr. 5, 2009, s. 541-9.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Re-evaluating the Rose approach: comparative benefits of the population and high-risk preventive strategies
AU - Cooney, Marie-Therese
AU - Dudina, Alexandra
AU - Whincup, Peter
AU - Capewell, Simon
AU - Menotti, Alessandro
AU - Jousilahti, Pekka
AU - Njølstad, Inger
AU - Oganov, Raphel
AU - Thomsen, Troels
AU - Tverdal, Aage
AU - Wedel, Hans
AU - Wilhelmsen, Lars
AU - Graham, Ian
AU - SCORE Investigators
N1 - Keywords: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Aspirin; Biological Markers; Blood Pressure; Cardiovascular Diseases; Cholesterol; Cohort Studies; Europe; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Mass Screening; Middle Aged; Patient Compliance; Population Surveillance; Preventive Health Services; Risk Assessment; Risk Factors; Risk Reduction Behavior; Smoking; Smoking Cessation; Time Factors; Treatment Outcome; Young Adult
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Options for the prevention of cardiovascular disease, the greatest global cause of death, include population preventive measures (the Rose approach), or specifically seeking out and managing high-risk cases. However, the likely benefit of a population approach has been recently questioned. OBJECTIVE: To compare the estimated effects of population strategies at varying levels of population-wide risk factor reduction and high-risk strategies at varying rates of screening uptake on cardiovascular disease mortality. METHODS: Data (of 109 954 participants) were pooled from six European general population cohort studies [the high-risk cohorts from the SCORE (Systematic COronary Risk Evaluation) dataset]. The effects of various population and high-risk strategies for the reduction of risk factors were estimated by calculating the change in 10-year risk of cardiovascular disease mortality (SCORE risk) before and after the particular intervention. Risk factors studied were: total cholesterol, blood pressure and smoking. RESULTS: At population level, if a 10-year reduction of blood cholesterol level of 10%, a BP reduction of 10% and a 10% reduction in the prevalence of smoking is considered possible, then 9125 lives per million of the population would be saved over 10 years. In contrast, an approach that treats all high-risk individuals with a polypill containing statin, three half-dose antihypertensives and aspirin, with a 20-80% uptake, would save 1861-7452 lives per million. However, the high-risk estimates are very optimistic, as their achievement would require complete compliance. CONCLUSION: High-risk and population strategies are complementary. These estimates of the benefits of each may be useful to health planners, when combined with their local knowledge. Recently, benefits of population strategies have been underestimated.
AB - BACKGROUND: Options for the prevention of cardiovascular disease, the greatest global cause of death, include population preventive measures (the Rose approach), or specifically seeking out and managing high-risk cases. However, the likely benefit of a population approach has been recently questioned. OBJECTIVE: To compare the estimated effects of population strategies at varying levels of population-wide risk factor reduction and high-risk strategies at varying rates of screening uptake on cardiovascular disease mortality. METHODS: Data (of 109 954 participants) were pooled from six European general population cohort studies [the high-risk cohorts from the SCORE (Systematic COronary Risk Evaluation) dataset]. The effects of various population and high-risk strategies for the reduction of risk factors were estimated by calculating the change in 10-year risk of cardiovascular disease mortality (SCORE risk) before and after the particular intervention. Risk factors studied were: total cholesterol, blood pressure and smoking. RESULTS: At population level, if a 10-year reduction of blood cholesterol level of 10%, a BP reduction of 10% and a 10% reduction in the prevalence of smoking is considered possible, then 9125 lives per million of the population would be saved over 10 years. In contrast, an approach that treats all high-risk individuals with a polypill containing statin, three half-dose antihypertensives and aspirin, with a 20-80% uptake, would save 1861-7452 lives per million. However, the high-risk estimates are very optimistic, as their achievement would require complete compliance. CONCLUSION: High-risk and population strategies are complementary. These estimates of the benefits of each may be useful to health planners, when combined with their local knowledge. Recently, benefits of population strategies have been underestimated.
U2 - 10.1097/HJR.0b013e32832b38a1
DO - 10.1097/HJR.0b013e32832b38a1
M3 - Journal article
C2 - 19773660
SN - 1741-8267
VL - 16
SP - 541
EP - 549
JO - European Journal of Cardiovascular Prevention & Rehabilitation
JF - European Journal of Cardiovascular Prevention & Rehabilitation
IS - 5
ER -