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Cochrane Database of Systematic Reviews

Intervenciones sobre múltiples factores de riesgo para la prevención primaria de la cardiopatía coronaria

Información

DOI:
https://doi.org/10.1002/14651858.CD001561.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 19 enero 2011see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Corazón

Copyright:
  1. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • Shah Ebrahim

    Correspondencia a: Department of Non‐communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK

    [email protected]

  • Fiona Taylor

    Department of Non‐communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK

  • Kirsten Ward

    Department of Twin Research & Genetic Epidemiology, King's College London, London, UK

  • Andrew Beswick

    MRC Health Services Research Collaboration, University of Bristol, Bristol, UK

  • Margaret Burke

    Department of Social Medicine, University of Bristol, Bristol, UK

  • George Davey Smith

    School of Social and Community Medicine, University of Bristol, Bristol, UK

Contributions of authors

G. Davey Smith and S. Ebrahim wrote the original review.

For the first update:

A. Beswick selected studies, extracted data, performed analysis and co‐wrote the review.
M. Burke ran searches, selected studies and extracted data.
S. Ebrahim selected studies, analysed data and co‐wrote the review.

For the second update:

K. Ward selected studies, extracted data, performed analysis and co‐wrote the review.
F. Taylor selected studies, extracted data, performed analysis and co‐wrote the review.
M. Burke ran searches and selected studies.
S. Ebrahim selected studies and co‐wrote the review.

Sources of support

Internal sources

  • MRC Health Services Research Collaboration, UK.

  • Systematic Reviews Training Unit, University of London, UK.

  • Department of Social Medicine, University of Bristol, UK.

  • Department of Epidemiology & Population Health, London School of Hygeine & Tropical Medicine, UK.

External sources

  • NHS Centre for Reviews & Dissemination, University of York, UK.

  • Health Education Authority, London, UK.

Declarations of interest

None known.

Acknowledgements

We are extremely grateful to the following investigators who provided us with data: M. Shipley (WHO Factories 1986), L. Wilhelmsen (Gothenberg Study 1986), I. Hjermann (Oslo Diet Antismoking), J. Shaten (MRFIT Study 1982), T. Miettinen (Finnish men 1985), J. Muir and T. Lancaster (OXCHECK 1994), J. Baron (Abingdon 1990), S. Pyke (Family Heart 1994 M), S. Boles (Take Heart 1995), T. Ekbom (CELL Study 1995), A. Goble and M. Worcester (FARIS). The following investigators replied to our request but were unable to provide us with further data for various reasons: G. Payne (HDFP trial 1970), D. Morisky (Johns Hopkins), R. Stamler (Stamler 1989), S. Knutson (Tromso 1991 M), C. Connell (Connell 1995), P. Whelton and M. Espelund (TONE 1998), A. Steptoe (Change of Heart 1999), G. Berglund (Persson 1996) and K. Emmons (WHP 1999). We would also like to thank M. Napoli (Center for Medical Consumers) for her help with the plain language summary.

We would also like to thank the following people for their help with the translation of papers so that we could complete the data extraction from non‐English papers: M. Podinovskaia (Immunology Unit at the London School of Hygiene and Tropical Medicine) ‐ Russian translation, C. To (CRASH Trials Co‐ordinating Centre at the London School of Hygiene and Tropical Medicine) ‐ Chinese Translation, E. Gohil (Global Change and Health at the London School of Hygiene and Tropical Medicine) ‐ Polish Translation, C. Pizzi (Medical Statistics Unit at the London School of Hygiene and Tropical Medicine) ‐ Italian Translation and R. Houben (Infectious Disease Epidemiology Unit at the London School of Hygiene and Tropical Medicine) ‐ Dutch Translation.

Version history

Published

Title

Stage

Authors

Version

2011 Jan 19

Multiple risk factor interventions for primary prevention of coronary heart disease

Review

Shah Ebrahim, Fiona Taylor, Kirsten Ward, Andrew Beswick, Margaret Burke, George Davey Smith

https://doi.org/10.1002/14651858.CD001561.pub3

2006 Oct 18

Multiple risk factor interventions for primary prevention of coronary heart disease

Review

Shah Ebrahim, Andrew Beswick, Margaret Burke, George Davey Smith

https://doi.org/10.1002/14651858.CD001561.pub2

1999 Apr 26

Multiple risk factor interventions for primary prevention of coronary heart disease

Review

Shah BJ Ebrahim, George Davey Smith

https://doi.org/10.1002/14651858.CD001561

Notes

This review will not be updated. The last two updates showed no substantive trials and few clinical events were found. It is highly unlikely that any further large scale, adequately powered trials will be conducted in the future. Small trials using only risk factor changes continue to be published but these do not contribute robust evidence to guide policy and practice due to inherent biases in their design. Owing to the development of very strong evidence to support pharmacological prevention of CVDs though use antihypertensives and statins there is much more emphasis on this approach used in conjunction with life‐style modification, making the findings from this review of much less relevance to contemporary public health practice. It is possible that new trials of multiple risk factor interventions will be mounted in low and middle income countries in the future and a separate review of their effects would be useful should this occur.