Eight projects that met the above criteria were reviewed. Cardiovascular risk factors had been reduced in several of these projects, but not substantially more in the intervention population than in the control populations. Likewise, morbidity and mortality did not decline more in the intervention populations than in the control populations.
Hence, there is no scientific evidence to support the start-up of new, large scale projects similar to the ones assessed.
Certain programs which did not meet the inclusion criteria are addressed briefly. Several of these programs reported a decline in risk factor levels, but adequate control populations are lacking. In randomized projects that addressed risk factors in high-risk individuals, the outcomes reported in the intervention groups were not generally superior to the outcomes in the control groups.
However, it is evident that risk factors such as smoking, high blood pressure, unhealthy diet, sedentary life style, and social factors play a major role in the incidence of myocardial infarction and stroke, and these diseases can, to some extent, be prevented if such risk factors are eliminated. There is a major need to further develop methodology in this field. Experience suggests that smaller, local projects may offer a better foundation for studies on how to more effectively prevent cardiovascular disease in the population.
Numerous projects aimed at preventing cardiovascular disease are underway in Sweden. Scientific expertise must be strengthened so the outcomes of preventive interventions can be more accurately assessed.