Extrait

Background and study aims Cardiovascular disease (CVD, disease of the heart and/or blood vessels) remains one of the main causes of death worldwide. One of the main factors contributing to CVD is raised blood pressure (hypertension), which is responsible for 5 in 10 deaths from coronary heart disease and 6 in 10 deaths from stroke. China has more than 160 million hypertensive patients, and the death rate for stroke is 4-6 times higher than Japan and the USA, while the amount of stroke and hypertension sufferers is far higher in rural areas (country) compared with urban areas (cities). In 2010, an initial study was conducted in two township hospitals of Zhejiang Province, China to understand the latest situation of CVD control and explore the feasibility of a program to lower the risk of CVD. Based on the feedback of this study, we propose to develop and test a package of cardiovascular risk reduction programs in Zhejiang China. The aim of this study is to explore the effectiveness and cost-effectiveness of a comprehensive CVD risk reduction program. Who can participate? Adults aged 50-74 years who have high blood pressure and live in the study area. What does the study involve? Participants are randomly allocated to one of two groups. Those in the first group continue to receive standard care for the duration of the study. Those in the second group take part in the CVD risk reduction program. This involves being prescribed a combination of drugs, including anti-hypertensives (drugs which lower blood pressure), low dose aspirin (Which thins the blood and prevents blood clots, lowering the risk of stroke) and a statin (which lowers cholesterol). Participants also receive support for taking their medication properly, attending appointments and making healthy lifestyle changes; and health education (including advice on smoking cessation, reduction of salt, sugar and oil in their diet, and physical exercise). The number of participants to have a CVD event (such as heart attack or stroke) is collected from Zhejiang provincial CVD surveillance system and double checked by interviewing patients at 12, 24 and 36 months. A sampling survey is also conducted at the start of the study and then after 12, 24 and 36 months to find out more about the patients' background, lifestyle and health. What are the possible benefits and risks of participating? Participants may benefit from a lower risk of developing CVD. Risks of participating are very low as the doses of drugs used will be modified on an individual basis. Any negative side effects of the drugs will be closely monitored by family doctors and village doctors. Where is the study run from? All township hospitals in 3 counties of Zhejiang province, apart from the hosptial that took part in the pilot study (China) When is the study starting and how long is it expected to run for? March 2012 to December 2017 Who is funding the study? 1. Comdis Health Services Delivery Research Consortium (UK) 2. Zhejiang Provincial Centre for Disease Control and Prevention (China) Who is the main contact? Professor Xiaolin Wei [email protected]

Critère d'inclusion

• Cardiovascular Diseases

Liens

• isrctn
• ictrp