PUB - Publikationen an der Universität Bielefeld

Objective-To prove the possibility of shifting distribution of cardiovascular risk factors for a whole population over time and thereby to influence the prevalence of the corresponding disease states, according to the theory stated by Geoffrey Rose in 1985. Design-Examination of standardised data from the German Cardiovascular Prevention Study (GCP), a seven year long, population-based, multicentre intervention trial, concerned with decreasing risk factors for cardiovascular disease. Setting and subjects-three cross sectional surveys of a population 25 to 69 years old in six study regions, and three nationwide cross sectional surveys in the former West Germany in 1984, 1988 and 1991. Main outcome measures-The relation between the population mean for systolic and diastolic blood pressure, total serum cholesterol, body mass index, and alcohol intake, and the prevalence of the corresponding disease states, as are systolic (greater than or equal to 140 and greater than or equal to 160 mm Hg) and diastolic hypertension (greater than or equal to 90 and greater than or equal to 95 mm He). hypercholesterolaemia (greater than or equal to 250 and greater than or equal to 300 mg/dl), overweight (body mass index greater than or equal to 30 kg/m(2)), and heavy drinking (weekly alcohol intake greater than or equal to 300 g/week). Results are expressed as linear regression equations and Pearson correlation coefficients. Results-The correlation between the mean population values and prevalence of disease was close for blood pressures and body mass index. The Pearson coefficients, corrected for the influence of values increased above borderlines, were 0.86 and 0.81 respectively for systolic blood pressure, 0.88 and 0.91 for diastolic blood pressure, 0.28 and 0.52 for cholesterol, and 0.86 for the body mass index. The coefficient for alcohol intake was 0.55. Conclusions-It seems possible to shift the risk distribution of a population for some physiological parameters over time with the effect of changing the disease prevalence. This strategy can be used successfully for specific preventive measures, as was strongly advocated by Geoffrey Rose.