Abstract

Mortality from cardiovascular diseases (CVD) increased steadily in Sweden during the 20th century. The county of Västerbotten had the highest mortality, leading to a community intervention programme called Västerbotten Intervention Programme (VIP).

The programme combines a population-based strategy directed towards the public and an invitation to all individuals (40, 50, 60 years) to a systematic risk factor screening and a health dialogue about lifestyle habits. VIP is one of few ongoing CVD prevention programs globally that are integrated into primary care routines, target selected age groups in middle age, and combine preventative strategies for population and high-risk individuals.

To evaluate the impact of VIP during the first 17 years of the programme, all eligible individuals and VIP participants were compared with the general Swedish population in a dynamic cohort study. All individuals aged 40, 50, or 60, residing in Västerbotten County between 1990 and 2006 (N=101,918) were followed from their first opportunity to participate in VIP until age 75, study end-point, or prior death. Primary outcomes were all-cause and CVD mortality.

There is strong evidence that the VIP has brought about a substantial reduction on premature mortality. We conclude that the VIP model of CVD prevention is able to impact on all-cause and cardiovascular mortality when evaluated according to the intention-to-treat principle.