ISFAHAN HEALTHY HEART PROGRAM:A COMPREHENSIVE INTEGRATED COMMUNITY-BASED PROGRAM FOR CARDIOVASCULAR DISEASE PREVENTION AND CONTROL. DESIGN, METHODS AND INITIAL EXPERIENCE 2000-2001

Isfahan Healthy Heart Program (IHHP) is a five to six year comprehensive integrated community based program for preventing and controlling of cardiovascular diseases (CVD) via reducing CVD risk factors and improvement of cardiovascular healthy behavior in target population. IHHP has been started in 1999 and will be last since 2004.
 Primary survey was done to collect baseline data from interventional (Isfahan and Najafabad Cities) and reference (Arak) communities. In a multistage sampling method, we select randomly 5 to 10 percent of households in clusters. Then individuals aged equal or higher than 19 years old were selected for entering to survey. In this way, data from 12600 individuals (6300 in interventional counties and 6300 in reference county) was collected and stratified due to their living area (urban vs. rural) and different age and sex groups. Cardiovascular risk factors (Hypercholesterolemia, Smoking, Hypertension, Diabetes Mellitus, Obesity) were investigated by laboratory tests (Lipid profile, FBS, OGTT), physical exam and standard questionnaires, in all ones. Nutritional habits, socioeconomic states, physical activity profiles and other healthy behaviors regarding to cardiovascular disease were assessed by validated questionnaires via interviewing to all individuals. Twelve leads electrocardiogram was done in all persons older than 35 years old. The prevalence of CVDs and distribution of CVD risk factors were estimated in this phase.
 In the 2nd phase, based on primary survey findings, we arranged a series of teams (worksite, children, women, health personnel, high risk patients, nutrition) for planning and implementation of program through interventional community for a 5-year period. Every team has its own target population and objectives and monitors its process during the study.
 At intervals (annually), some local and small surveys with a random sampling will be conducted to assess and monitor the program and its potency to cope with objectives. We will follow our high-risk ones in a cohort to obtain the risk chart for our community at the end of the program. Myocardial infarction and stroke registry center collects data, continuously, from all hospitals and other medical centers in the interventional and reference communities. These data (Death due to CVD, MI and Stroke) are the end outcome variables in this program.
 Secondary survey as like as the primary survey will be conducted at the end of the program in both community to assess the efficacy of program for controlling and somehow reducing the CVD risk factors potency in the interventional community versus reference community