CARDIOVASCULAR RISK FACTOR CHANGES IN THE KILKENNY HEALTH PROJECT - ACOMMUNITY-HEALTH PROMOTION PROGRAM

The Kilkenny Health Project was a community research and demonstration programme which aimed to reduce risk of cardiovascular disease in a c ounty in the south-east of Ireland with a total population of approxim ately 70 000. The health promotion programme was carried out in Kilken ny from 1985 to 1992. Outcome evaluation was by means of population su rveys of independent samples of men and women aged 35 to 64 years in K ilkenny (n approximately 800) and in the reference county (n approxima tely 600) in 1985/1986 and in 1990/1991. Survey methods for health beh aviour questionnaires and risk factor measurements were similar to tho se of the WHO MONICA Project. Mean systolic blood pressure (SBP) decli ned significantly (P<0.01) in men and women in both counties, from 144 .0 by 5.4 mmHg and from 143.2 by 5.4 mmHg in men and from 139.5 by 7.7 mmHg and from 136.5 by 6.6 mmHg in women in the intervention and refe rence counties. The prevalence of hypertension declined from 23.1% by 2.8% and from 26.1% by 6.0% in men in the two counties. Prevalence dec lined from 24.1% by 6.2% (P<0.05) in women in the intervention county but was unchanged increasing by 0.5% from 17.5%, in women in the refer ence county. Mean serum total cholesterol declined fram 6.04 mmol.l(-1 ) by 0.09 mmol.l(-1) and from 6.00 by 0.44 mmol.l(-1) (P<0.01) in men and from 6.01 by 0.36 (P<0.01) and from 5.90 by 0.31 (P<0.01) in women in the intervention and reference counties, respectively. Cigarette s moking prevalence declined from 27.7% by 0.7% and from 29.8% by 2.6% i n men and from 30.3% by 5.5% and from 27.7% by 2.6% in women in the tw o counties. Mean body mass index (BMI) increased from 26.4 by 0.4 kg.m (-2) and from 26.8 by 1.0 kg.m(-2) (P<0.01) in men and from 25.5 by 0. 4 and from 25.6 by 1.3 kg.m(-2) (P<0.01) in women in the intervention and reference counties. Overall, changes in risk factor levels were si milar in the intervention and reference counties. There were significa nt reductions (P<0.01) in the 5-year risk of a coronary, heart disease (CHD) event as estimated using the Dundee Risk Score in men and women in both counties. This was consistent with the decline in CHD mortali ty at national level between the two surveys. The reasons why greater changes over time were not detected in the intervention compared to th e reference area are discussed.