Miran F.:Kenda, University Medical Center, Dpt. for Vascular Medicine, Dpt. for Cardiology, Slovenian Society of Cardiology, Ljubljana, Slovenia

Integrated nationwide preventive strategy in Slovenia

Background. As in all developed countries, also in Slovenia cardiovascular (CV) diseases are the cause of nearly 40% of all deaths, the prevalence of atherosclerotic diseases is about 6%, while over 10% of all Slovenes are at high CV risk (over 20% according to Framingham risk charts). With the exception of smoking, the prevalence and intensity of other major risk factors increased during the last decade of the 20 th century. Methods. Worrying situation regarding CV risk situation led to a strategic decision to implement integrated program of primary CV prevention . As one of the key steps, already in 1999, Slovenian Society of Cardiology realized the idea to establish Slovene Forum on CV Diseases Prevention, joining all relevant national professional and scientific societies and institutions, governmental agencies, as well as NGOs. Results. Already in the year 2000, the consensus on national prevention guidelines was reached as well as the action plan which outgrow into comprehensive “Nationwide Program on Primary Prevention of CV Diseases” was adopted. The program which started officially in 2002 consisted of population screening and identification of individuals at high CV risk, followed by systematic health education measures (performed within the network of 61 state appointed health education centers (HECs) at the primary care level ) and other necessary diagnostic and therapeutic interventions. In five years, t he program will screen and register the majority of the adult population (all men from 35-65 and women from 45-70 years of age). During the first three years, 310,706 preventative visits were performed and more than 54,000 individuals (17,4%) at high CV risk were treated in HECs. Preliminary results of the recent cross-sectional study showed that our joint efforts have already given considerable positive effects, because the number of adults at high risk decreased significantly in the period from 1997-2003, in the age group from 50-59 from 53% to 39,5% (-25,5%) and from 17,5% to 10% (-43%) for men and women, respectively , while in the age group from 60-64, these decreases were from 86% to 63% (-26,8%) for men and 33% to 27% (-18,2%) for women. Conclusion. Cautious and quality implementation of the programme and f urther monitoring of its results will surely justify the invested funds and endeavours of all of the involved partners.