THE LONG-TERM EFFECTS OF A CARDIOVASCULAR-DISEASE PREVENTION TRIAL - THE STANFORD 5-CITY PROJECT

Objectives. This study examined long-term effects of a health-educatio n intervention trial to reduce the risk of cardiovascular disease. Met hods. Surveys were conducted in California in two treatment and two co ntrol cities at baseline (1979/1980), after the 6-year intervention (1 985/1986), and 3 years later at follow-up (1989/1990). Net treatment/c ontrol differences in risk-factor change were assessed for women and m en 25 to 74 years of age. Results. Blood pressure improvements observe d in all cities from baseline to the end of the intervention were main tained during the follow-up in treatment but not control cities. Chole sterol levels continued to decline in all cities during follow-up. Smo king rates leveled out or increased slightly in treatment cities and c ontinued to decline in control cities but did not yield significant ne t differences. Both coronary heart disease and all-cause mortality ris k scores were maintained or continued to improve in treatment cities w hile leveling out or rebounding in control cities. Conclusions. These findings suggest that community-based cardiovascular disease preventio n trials can have sustained effects. However, the modest net differenc es in risk factors suggest the need for new designs and interventions that will accelerate positive risk-factor change.