40-Year Effort in One Rural County to Prevent CV Disease Found Successful — Physician’s First Watch

Medical News |
January 14, 2015

40-Year Effort in One Rural County to Prevent CV Disease Found Successful

By Larry Husten

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

In one poor rural county, a 40-year program to combat cardiovascular disease appears to have reduced hospitalization and mortality rates compared with similar counties over the same period, a JAMA study finds.

Franklin County, Maine, began a comprehensive effort to lower cardiovascular risk in 1970. The community-led program, which resulted in over 150,000 patient encounters, sought to help residents lower elevated blood pressure and cholesterol, quit smoking, improve their diets, and increase their physical activity.

When compared with other Maine counties, Franklin County had a lower-than-expected, income-adjusted total mortality rate after the program started. There was a similar drop in hospitalization rates, resulting in a reduction of $5.4 million in hospital charges annually.

In addition, blood pressure control increased from 18.3% in 1975 to 43.0% in 1978. Control of hyperlipidemia increased from 0.4% in 1986 to 28.9% in 2010.

Editorialists write that, while not a randomized trial, the findings appear plausible given that the individual interventions have been found to be effective previously.

Reader Comments (1)

H ROBERT SILVESTEIN Physician, Cardiology, Preventive Medicine Center Hartford CT

Disease prevention is important. But at what TOTAL cost (minus $ saved from reduced disease expression & hospital admissions)? Anything can be improved if enough (? excessive) money is thrown at it. While laudable, is it cost effective? HRS, MD, FACC

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