A MULTIFACTORIAL CORONARY HEART-DISEASE P REVENTION PROGRAM IN MOSCOW- LONG-TERM OUTCOMES (A 10-YEAR FOLLOW-UP)

The paper provides the results obtained from implementation of the pro gramme on multifactorial prevention of coronary heart disease (CHD) in Moscow, which provided strong evidence for a reduction in the levels of major risk factors and mortality from cardiovascular diseases, incl uding coronary heart disease. The efficiency of comprehensive prophyla ctic measures in persons with clinical signs of CHD showed up at year 3 of their implementation and retains in subsequent years. At the same time in persons without CHD signs a mortality reduction starting at y ears 4-5 of the follow-up virtually came to an end when a further acti ve intervention ceased. The impact of aftereffect of active prophylact ic measures after intervention cessation turned out to be different in the examinees at various baseline risk factor levels, which suggests that continuous prophylaxis should be done, on the one hand, and it re quires a differential approach, on the other. The reduction in the ext ent and mean levels of major risk factors, which had been achieved dur ing a 5-year prophylactic intervention, retained, though it was less p ronounced and 10 years later. However, this was followed by an increas e in the mortality from myocardial infarction and stroke and their inc idence in the population that had undergone active prophylactic measur es, though the value of these parameters was lower at the end of the t enth year than in the controls.