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A PUZZLING FAILURE OF CARDIAC RISK REDUCTION.
Unexpected findings have emerged from a 15-year Finnish study, which reports that subjects undergoing a cardiovascular risk-reduction program had a higher death rate than the control group.
In 1974, investigators randomized 1222 middle-aged male business executives to either a control group or a five-year risk-reduction program, which included drug and dietary treatment for hypertension and lipid abnormalities. All subjects had at least one cardiovascular risk factor. When the risk-reduction program ended in 1979, its participants were more likely than controls to have lost weight and reduced their blood pressure and cholesterol levels. By 1985, however, the only significant difference between the two groups was a lower average body weight in men who had followed the risk-reduction program.
Surprisingly, mortality data collected from 1974 to 1989 showed that the overall risk of death was 45 percent higher in the risk-reduction group than in the control group. For cardiovascular death, the relative risk associated with the intervention was 2.4. Moreover, 13 violent deaths (suicides or accidents) occurred in the risk-reduction group, versus only one in the control group.
There was no apparent explanation for these findings. The investigators stress that the results do not call into question the merit of multifactorial cardiovascular risk- factor reduction, but point out the need for further research into this field. An accompanying editorial agrees, saying that although the findings could be due to chance, they encourage "a healthy disquiet."
— THL
Published in Journal Watch General Medicine September 10, 1991
Citation(s):
Paul O; Hennekens CH. The latest report from Finland: a lesson in expectations. JAMA 1991 Sep 4 266 1267-1268.
- Medline abstract (Free)
Strandberg TE et al. Long-term mortality after 5-year multifactorial primary prevention of cardiovascular diseases in middle-aged men. JAMA 1991 Sep 4 266 1225-1229.
- Medline abstract (Free)
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