Hypertension and cardiovascular diseases intervention in the capital steel and iron company and Beijing Fangshan community

Abstract

Two intervention studies are described involving >110,000 subjects in each. The first was in a steel factory where one intervention site had health promotion, aimed at altering diet, and particularly reducing salt and fat intake, modest alcohol drinking and smoking cessation, together with a high-risk strategy of hypertension control. The second study involved similar population and high-risk strategies in three of five rural communities. Significant reductions occurred in both intervention and control factory sites in blood pressure, with greater falls in the intervention site, together with a marked additional reduction in salt intake and better control of hypertension. In the rural communities, blood pressure fell in all communities to a more modest degree than in the factory, but with greater blood pressure falls, together with greater smoking cessation and more modest alcohol drinking in the intervention compared with the control communities. Stroke mortality fell by 74.3% and all strokes morbidity by 54.7% in the steel factory as a whole. In the rural communities, the intervention sites showed significantly greater falls in stroke rates than in the control communities. These data show the value and effectiveness of combining a population and high-risk strategy for controlling blood pressure and cardiovascular diseases in both a rural setting and in the work place in China.