THE GERMAN CARDIOVASCULAR PREVENTION STUD Y - SOCIAL GRADIENT FOR THENET EFFECTS IN THE PREVENTION OF HYPERCHOLESTEROLEMIA

Hypercholesterolemia is considered an important risk factor for cardio vascular disease. The net effects of 7 years of a community prevention programme using principally a highrisk strategy (screening, referrals to general practitioner) in the German Cardiovascular Prevention Stud y (GCP) are analysed according to socioeconomic status (SES). Choleste rol was measured in three subsequent cross-sectional population sample s of adults (ages 25-69 years) in 1984-1985, 1988 and 1991-1992 in the regions of Berlin, Bremen, Stuttgart, Karlsruhe with Bruchsal/Mosbach , and Traunstein (n = 11 548, 8743, 8636), in the region of Stuttgart only (n = 1791, 1437, 1313) and in the entire West German population ( n = 4790, 5335, 5311) as reference. SES was determined by an additive, multiple index. Variations of means for phases and regions and result ant, net differences were calculated. From 1984-1985 to 1991-1992 chol esterol declined from 232.7 to 231.8 mg/dl in the overall regions, fro m 232.0 to 230.5 mg/dl in Stuttgart, but increased from 233.5 to 236.9 mg/dl in the reference region. In the combined regions net difference s according to SES were -4.2 %**(1)) for the upper class, -1.6 %** fo r the middle class and -0.3 % for the lower class. Similar results wer e found comparing Stuttgart with the reference region (-5.4 %**, -1.4 %, -0.1 %). The GCP intervention for hypercholesterolemia was success ful basically only for the upper class, if net differences for the mea ns are calculated. Prevention of hypercholesterolemia increased the so cial gradient in the pooled intervention regions and in Stuttgart.