Changes in arterial pressure and smoking habit following 3 years of multifactorial intervention

BACKGROUND: The feasibility of successfully reducing cardiovascular risk factors is supported by large studies. Nevertheless, controversy remains about the actual efficacy of some lifestyle interventions. This report assess the effectiveness of different levels of intervention at the work-site on blood pressure and smoking. METHODS: At the beginning of the program 1.193 men and 362 women were included in it. Individualized face-to-face counseling was given to employees by four different occupational physicians. After 3 years, 980 individuals remained in the study. The differences among the four groups allowed us to distinguish three different levels of intensity of interventions and a fourth group that was the reference one. Observed changes in blood pressure were compared using analysis of covariance. Adjusted odds ratio of smoking quit rates were calculated by logistic regression. RESULTS: Intensive intervention was significantly different from control group and the group of mild intervention. Moderate intervention was the only one to bring about a significant reduction of arterial blood pressures. This reduction was consistent with the lower threshold used in this group to classify diastolic blood pressure as high. Smoking quit rate was 22% for intensive and moderate interventions. Adjusted odds ratio for quitting smoking was 5.81 (95% CL 1.29-26.14) for moderate and 8.2 (IC 95% 1.75-38.46) for intensive intervention. CONCLUSIONS: A lower threshold for starting intervention measures on blood pressure is suggested to achieve better results. As the intensity of interventions was stronger, smoking quit rates were higher.