Evolution of ischemic heart disease risk factors in "The Bucharest Multifactorial Preventive Trial of Coronary Heart Disease" after 15-year follow-up.

The paper presents the evolution of the levels of smoking, hypercholesterolemia, essential hypertension and obesity in the course of a prophylactic action carried out for 15 years (1971-1986) in a group of 5000 males aged 40-60 years. In the group still available after 15 years of follow up consisting of 2000 subjects, a decrease was obtained in the number of smokers, from 22.3% to 5.

A longitudinal study, for 15 years, of the myocardial infarction, in a population of middle aged men.

The long-term evolution of the patients with incident myocardial infarction (MI) was studied in a group of 5,000 men ranging in age from 40 to 60 years, included in an action of primary prevention of arterial hypertension (AHT) and coronary heart disease, in comparison with a second group of 5,000 other men with similar age and occupation, selected at random, who received medical assistance without primary prevention. The incidence of MI was of 2.34% (111 cases) in the group of intervention, with a cardiovascular mortality of 46.

The predictive value of some major ECG changes.

Out of a group of 5,000 men included in an action of primary prevention of coronary heart disease and arterial hypertension, started in 1971 in the "N. Gh. Lupu" Institute of Internal Medicine--Bucharest, the authors have selected the subjects presenting major ST--T changes and conduction troubles.

The Bucharest Multifactorial Prevention Trial of Coronary Heart Disease--ten year follow-up: 1971-1982.

The trial begun in 1971 and the paper brings the results after a ten-year follow-up. Both the intervention and control group contained 5000 men with a similar socioeconomic and professional structure; the intervention group was examined every six months in the first 5 years and annually in the second phase. The control group was examined "only after" 5 years and a second time at the final moment.

The Bucharest multifactorial prevention trial. The changes of morbidity and of general and specific mortality.

The paper presents the results of the Bucharest multifactorial prevention trial of coronary heart disease, concerning changes in cardiovascular morbidity and mortality during the first 5-year-period of follow-up. The age adjusted 5-year-rates disclose important reductions in the intervention group in comparison with the control one: for hard events (myocardial infarction, stroke, acute coronary insufficiency)--by 41%; for myocardial infarction--by 35%; for coronary mortality--by 38%; for stroke--by 39%; for cardiovascular mortality--by 30%. The decrease of hard events, myocardial infarction and stroke incidences are statistical significant.

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977).

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death.

Coronary heart disease and its risk factors in a group of 5,000 middle aged men in urban environment.

The results obtained at entry in the subjects included in a pilot study (Institute of Internal Medicine, Bucharest) for the detection and prevention of coronary heart disease and hypertension, are presented. These data are the prevalences of the risk factors of coronary heart disease (high serum cholesterol, hypertension, smoking, overweight, diabetes, nonspecific minor ECG signs, family history), as well as the prevalences of the various forms of coronary heart disease. The study of the frequency distribution of biologic parameters likely to become risk factors showed that in middle aged subjects the upper limit of the normal should be lowered from the 95th percentile to the 76th one.

Coronary heart disease and risk factors in some special type collectivities.

Transversal epidemiologic investigations carried out in different populations from several regions of Romania : Gurghiu Valley (lumberjacks from a mountain region), Danube Delta and Razelm lagoon complex (fishermen), and Bucharest have shown that, in spite of the high caloric value of food and even of a high intake of saturated fats, mean serum cholesterol is lower in the rural areas than in Bucharest, probably owing to the strenuous physical work. However, except myocardial infarction, more frequent in the urban than in the rural regions, the other forms of coronary heart disease have a relatively higher frequency in villages, particularly atrial fibrillation and ECG signs of ischemia. These findings might be explained by a greater prevalence of hypertension in these populations.

Familial clustering of degenerative cardiovascular diseases.

In two geographical areas; the Gurghiu Valley, in a mountain region, and the village of Jurilovca on the shores of the Razelm lagoon, investigations were performed in 390 subjects of both sexes over 20 years of age, first degree relatives of healthy index subjects (males aged 40 to 60 years) and 298 subjects of both sexes over the of 20, first degree relatives of index-subjects with coronary heart disease and/or hypertension. The prevalence of these diseases was found to be 40% higher in the families of diseased subjects. The authors assume the participation of a genetic factor in the etiology of these two degenerative cardiovascular diseases.