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The Swedish model for CVD prevention: Public Health cultivation combined with individual health dialogues in Primary Care

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Organised by the Prevention Research Group at the Primary Care Unit

In Sweden, mortality from cardiovascular diseases (CVD) increased steadily during the 20th century and in the mid-1980s. The county of Västerbotten had the highest mortality. Therefore, a community intervention programme was launched – the Västerbotten Intervention Programme (VIP). The programme combines a population-based strategy directed towards the public and an invitation to all middle-aged persons at ages 40, 50 and 60 years for a systematic risk factor screening and a individual health dialogue about lifestyle habits. VIP is one of very few ongoing sustainable CVD prevention programs globally, that are integrated into primary care routines, that target selected age-groups in middle-age, and that combine low-risk population and high-risk individual level strategies for prevention

To evaluate the impact of VIP during the first 17 years of the programme, (a) all eligible individuals (target group impact), and (b) VIP participants were compared with the general Swedish population in a dynamic cohort study. All individuals aged 40, 50 or 60, residing in Västerbotten County, Sweden, between 1990 and 2006 (N=101 918) were followed from their first opportunity to participate in VIP until age 75, study end-point or prior death. Primary outcomes were all-cause and CVD mortality.

There is strong evidence that the VIP has brought about a substantial reduction on premature mortality. We conclude that the VIP model of CVD prevention is able to impact on all-cause and cardiovascular mortality when evaluated according to the intention-to-treat principle.

This talk is part of the Primary Care series.

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