Effectiveness of interventions to reduce coronary heart disease risk.

BACKGROUND Coronary heart disease (CHD) is an important cause of morbidity and mortality in industrialized countries, and its incidence is increasing in the developing world. The effectiveness of interventions in developing countries has been questioned in view of the overwhelming burden of other health problems in such environments. OBJECTIVE To determine the effectiveness of coronary heart disease risk reduction interventions. METHODS The effects of lipid lowering interventions as well as dietary and lifestyle modifications on some risk factors of CHD were studied retrospectively in 47 males and 53 female patients [aged 33 to 61 years; mean age 47.20 ±14.17 years] attending a lipid clinic in Saudi Arabia. The main outcome measures were reductions in the values of the body mass index (BMI), blood pressure, blood glucose and lipid levels, as well as absolute reductions of risk category. RESULTS The interventions were associated with reduced BMI by 2.75 percent (p<0.05), systolic pressure by 3.05% (p=0.12), diastolic pressure by 5.13% (p<0.05), blood glucose by 6.51% (p<0.05), total cholesterol by 16.35% (p<0.05), LDL-cholesterol by 4.81% (p<0.05) and triglyceride by 35.01% (p<0.05). HDL-cholesterol remained within the normal range before and after the interventions in all patients. Following the interventions, the absolute risk reductions in category 1 were 45.51% and 53.35%, for males and females, respectively. In category 2, the absolute risk reductions were 30.05% and 45.67%, for males and females, respectively. In category 3, the absolute risk reductions were 100% for both sexes. For the entire study population, the absolute risk reductions were 48.65% in category 1 and 38.10% in category 2, while the percentage of patients with one or no risk factor (category 3) increased by 62%. CONCLUSION Lipid-lowering interventions appear to be as effective in reducing CHD risk in Bisha patients as in other populations. Appreciable absolute risk reductions can be achieved within a short period of time in all patients, irrespective of their initial risk status.