Promoting women's heart health by screening for vascular risk factors among middle-aged women: methods and baseline results from a preventive trial

Abstract

The aim of this trial was to test the feasibility of a screening method based on the well-known risk factors of cardiovascular disease (CVD), and to evaluate the efficacy of 2 preventive strategies to lower the level of risk factors. Par- ticipants (n = 755) were female employees contacted during their health check visit at the age of 40, 45, 50, or 55 years. The risk-index consisted of body mass index, total serum cholesterol level, blood pressure, smoking and exercise activity. Psychosocial factors (e.g. vital exhaustion, optimism-hopelessness) were assessed with self-report questionnaires. High- risk women were invited to participate in a preventive intervention. Simple crossover design was used to evaluate the effi- cacy of personal feedback and health education as compared with feedback and group-based intervention programme. Fol- low-ups were completed at 6 and 12 months. Nearly one third (29.0 %) of the participants scored over the previously es- tablished risk-limit. Indicators of negative affectivity, i.e. vital exhaustion and hopelessness, associated significantly with the risk index after controlling for age and education. The feasibility of the screening method in an occupational health care setting proved to be good. The proportion of high-risk women was higher than expected but remained clearly lower than the 41 % prevalence in corresponding male cohorts. Results suggest that the screening method offers a good starting point for prevention.