COMMUNITY INTERVENTION AGAINST NON-INSULIN-DEPENDENT DIABETES-MELLITUS (NIDDM) AND CARDIOVASCULAR-DISEASE - A STUDY BASED ON SWEDISH HEALTH-CARE

The overall aim of this study was to examine whether a community inter vention program in a geographically defined population affected biolog ic risk factors in a 5-year perspective. As a first step, different or ganizations in the community were encouraged to participate in improvi ng the population's way of living with respect to lifestyle factors su ch as diet, exercise, and smoking habits. The study was performed in O lofstrom (N = 15,000), a municipality in southern Sweden with a relati vely high mortality from cardiovascular disease (CVD). Samples of the population in the age group from 30 to 64 years were invited in 1989, 1991, and 1993 to cross-sectional studies with CVD risk factor screeni ng. Rotating samples with 50% replacement on each occasion were used t o measure changes in blood glucose, plasma cholesterol, blood pressure , body mass index, and smoking habits. In both men and women, there we re significant decreases in blood glucose, plasma cholesterol, and dia stolic blood pressure between 1989 and 1991. No further decrease was s een between 1991 and 1993. These results were supported by cohort anal yses of individuals who participated twice in the cross-sectional stud ies. There were no changes of body mass index or smoking habits from e ither 1989-1991 or 1991-1993. To our knowledge, a reduction of the blo od glucose level in a geographically defined population has not previo usly been shown after a community intervention program has been implem ented. This reduction is of importance because impairment of the gluco se homeostasis is associated with a two- to threefold increase in card iovascular mortality. Thus our study model using the established Swedi sh primary health care organization in cooperation with different orga nizations in the municipality seems to be of value when implementing l ifestyle changes and promoting better health.