Long-term Outcome of Cardiovascular Prevention: A Nijmegen Academic Family Practices Network Study

Context: Cardiovascular disease is common and preventable. Primary care is the preferred setting for individual prevention and management. Objective: This study analyzed the long-term outcome of cardiovascular risk in a family practice pop-ulation. Design: A longitudinal cohort analysis of cardiovascular outcome after 18 years, in participants of a randomized controlled trial (RCT) of cardiovascular prevention. In 1977, a RCT with cluster random-ization at practice level assessed the effects of a 1-year preventive intervention in patients 20 to 50 years of age. Cardiovascular risk factors (smoking, body mass index, blood pressure, serum choles-terol, family history, and physical activity) were measured and intervention was a practice-nurse sup-port for the follow-up of those at elevated risk. The control practices prescribed care as usual. Between 1994 and 1995, all participants were approached again, to analyze subsequent (cardiovascular) mortal-ity and morbidity and their cardiovascular risk in a random sample. Setting: The Nijmegen Academic Family Practices Network, The Netherlands. Participants: All participants (7092) of the 1977 screening for follow-up morbidity and mortality, 2600 for re-measurement risk factors