Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 15;19(1):202.
doi: 10.1186/s12889-019-6514-x.

Do cardiovascular disease prevention programs in northern Sweden impact on population health? An interrupted time series analysis

Miguel San Sebastián  1 , Paola A Mosquera  2 , Per E Gustafsson  2
Affiliations

Do cardiovascular disease prevention programs in northern Sweden impact on population health? An interrupted time series analysis

Miguel San Sebastián et al. BMC Public Health. .

Abstract

Background: Cardiovascular disease (CVD) is the main cause of morbidity and mortality in Sweden. This study aims to assess the impact of a CVD intervention implemented in 1993 in northern Sweden on the reduction of premature ischemic heart disease (IHD) morbidity and mortality in women and men during the period 1987-2013.

Methods: An ecological controlled interrupted time series design, with pre-intervention period defined as 1987-1993 and post-intervention period 1994-2013 was carried out. For each year, IHD events, stratified by sex, were retrieved from national registers.

Results: Impressive reductions on IHD premature morbidity and mortality were observed to a similar degree in both the intervention county and the other comparison counties across the last 27 years. Significant differences in the pre-post intervention trends indicating the intervention group had smaller reductions than expected from its pre-intervention trend and the trend of control counties were found among men for both IHD morbidity and mortality. A similar pattern was observed among women but without significant differences.

Conclusions: Taken together, the data do not support that the intervention has contributed to an additional reduction on IHD morbidity and mortality, above and beyond that which is already seen in neighbouring counties without similar programs.

Keywords: Interrupted time series analysis; Intervention; Ischemic heart disease; Morbidity; Mortality; Northern Sweden.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Percentage reduction of IHD morbidity and mortality by sex in Västerbotten (intervention county) and three control counties (Norrbotten, Västernorrland and Jämtland) during the periods of 1987–2013 and 1994–2013
Fig. 2
Fig. 2
Premature Ischemic Heart Disease (IHD) morbidity (per 100,000 population) trends with fitted regression line before (1987–1993) and after (1994–2013) intervention started in the intervention county (Västerbotten) and control counties (Norrland; including Norrbotten, Västernorrland and Jämtland) in men (a) and women (b)
Fig. 3
Fig. 3
Premature Ischemic Heart Disease (IHD) mortality (per 100,000 population) trends with fitted regression line before (1987–1993) and after (1994–2013) intervention started in the intervention county (Västerbotten) and control counties (Norrland; including Norrbotten, Västernorrland and Jämtland) in men (a) and women (b)
See this image and copyright information in PMC

Comment in

References

    1. Berg J, Bjorck L, Lappas G, O’Flaherty M, Capewell S, Rosengren A. Continuing decrease in coronary heart disease mortality in Sweden. BMC Cardiovasc Disord. 2014;14:9. doi: 10.1186/1471-2261-14-9. - DOI - PMC - PubMed
    1. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J. 2014;35(42):2929. doi: 10.1093/eurheartj/ehu299. - DOI - PubMed
    1. Bjorck L, Capewell S, O'Flaherty M, Lappas G, Bennett K, Rosengren A. Decline in coronary mortality in Sweden between 1986 and 2002: comparing contributions from primary and secondary prevention. PLoS One. 2015;10(5):e0124769. doi: 10.1371/journal.pone.0124769. - DOI - PMC - PubMed
    1. Swedish National Institute of Public Health Public health priorities in Sweden Stockholm: Swedish National Institute of Public Health; 2011 [Available from: https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarki....
    1. World Health Organization. Prevention of cardiovascular disease: guidelines for assessment and management of total cardiovascular risk. Geneve: World Health Organization; 2007.

LinkOut - more resources