Comparing primary prevention with secondary prevention to explain decreasing Coronary Heart Disease death rates in Ireland, 1985–2000
2007

Impact of Primary vs. Secondary Prevention on Coronary Heart Disease Deaths in Ireland

Sample size: 3800000 publication 10 minutes Evidence: high

Author Information

Author(s): Zubair Kabir, Kathleen Bennett, Emer Shelley, Belgin Unal, Julia A Critchley, Simon Capewell

Primary Institution: Harvard School of Public Health

Hypothesis

Primary prevention might be more favourable than secondary prevention in reducing coronary heart disease deaths.

Conclusion

Primary prevention achieved a two-fold larger reduction in coronary heart disease deaths compared to secondary prevention.

Supporting Evidence

  • Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in major risk factors.
  • Smoking prevalence declined by 14%, resulting in about 685 fewer deaths.
  • Total cholesterol concentrations fell by 4.6%, leading to approximately 1,300 fewer deaths.
  • Diastolic blood pressure fell by 7.2%, resulting in about 170 fewer deaths.
  • 68% of the deaths prevented were in people without recognized CHD.

Takeaway

Helping healthy people avoid heart disease is more effective than just treating those who already have it.

Methodology

The IMPACT CHD mortality model was used to analyze data on CHD patient numbers, treatment uptake, risk factor trends, and mortality benefits.

Potential Biases

Potential bias from using data from studies with geographic or selection constraints.

Limitations

The study relied on data that may have geographic or selection bias and only considered three main risk factors.

Participant Demographics

Irish population aged 25 to 84 years.

Digital Object Identifier (DOI)

10.1186/1471-2458-7-117

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