News Release

Community programs can help prevent heart disease

Peer-Reviewed Publication

Center for Advancing Health

Community heart health programs with links to local hospitals can help reduce cardiovascular disease deaths, suggest the results of a study.

Researchers based these findings on an analysis of one such community program in rural Franklin County, ME. "The objective of the program was to reduce cardiovascular risk factors by achieving and maintaining blood pressure, cholesterol, and smoking goals," said lead author N. Burgess Record, MD, of Franklin Memorial Hospital in Farmington, ME.

To that end, program nurses at worksites and other community settings reviewed patients' medical histories and provided screening tests, referrals, counseling, and education on lifestyle issues such as smoking, exercise, and stress. The program also tracked patients' progress and generated follow-up reminders for them and reports to the patients' primary physicians. The program, which continues as a hospital-based model for community health in Maine, was funded by grants, client donations, and small fees.

Researchers at the Maine Health Research Institute compared heart disease death rates in Franklin County with demographically similar nearby Maine counties without such programs. They examined 21 years of data spanning from 1974 to 1994, during which time program nurses provided approximately 120,000 patient encounters with over one-half of the area's adult population.

The Franklin program was associated with a decrease in cardiovascular death rates, the researchers found. During the 21-year study period, the Franklin County heart disease death rate was, on average, 9 percent lower than Maine's, and its total death rate was 5 percent lower than Maine's. The study results appear in the July issue of the American Journal of Preventive Medicine.

The researchers also noted that, within Franklin County, ups and downs in heart disease death rates over the 21-year study period mirrored the program's financial state -- and subsequent ability to provide services -- which varied depending on the local economy.

"Periods of intense community program activity produced large numbers of clients, dynamic interaction between the program and community physicians, energetic crusading through the media, and coincided with national efforts to promote hypertension, cholesterol, and smoking awareness, detection, and control," said Burgess Record.

Previous U.S.-based studies have not found an association between large-scale community health programs (such as the Franklin program) and reduced cardiovascular deaths, although several small-scale community efforts have been shown to reduce cardiovascular illness risk. The Franklin program may have succeeded where others failed because of its long history in the community, its tracking of patient risk factors, its professional nursing staff, and its relationship with primary medical care, according to the study.

"Community-based, nurse-mediated programs that integrate community prevention measures with local medical practice may help blunt the current worldwide cardiovascular disease epidemic," said Burgess Record.

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This study was supported in part by a grant from the Maine Bureau of Medical Services.

The American Journal of Preventive Medicine, sponsored by the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine, is published eight times a year by Elsevier Science. The Journal is a forum for the communication of information, knowledge, and wisdom in prevention science, education, practice, and policy. For more information about the journal, contact the editorial office at 619-594-7344.

Posted by the Center for the Advancement of Health
http://www.cfah.org .
For information about the Center, call Petrina Chong, (pchong@cfah.org ) 202-387-2829.


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