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Objective: To explore the feasibility and effectiveness of worksite-based cardiovascular disease (CVD) prevention and control program in urban population of China., Methods: Worksite-based intervention program was implemented 110 000 employees at Capital Iron and Steel Company of Beijing (CISC) focusing on primary prevention for CVD and control of hypertension. Intervention components comprised of infrastructure setting-up, health education and health promotion, professional training, detection and management of hypertensive patients, and reasonably readjusting their diet structure focusing on salt intake reduction, reducing their overweight, quitting smoking, and restricting alcohol consumption in high-risk population. Changes in level of risk factors, incidence and mortality of stroke and coronary events and their trend were evaluated between the intervention group at CISC and eight simultaneously parallel reference groups in other provinces outside Beijing with population surveillance data., Results: Major risk factors for CVD, including blood pressure, body mass index and serum cholesterol level, decreased relatively in intervention population at CISC during 1974 to 1998, while those in majority of eight parallel reference groups at different provinces of China significantly increased at the same time. Systolic blood pressure (SBP) decreased by 0.8 mm Hg and 4 mm Hg in average for men and women, respectively, and their diastolic blood pressure (DBP) remained the same as baseline for both men and women at CISC, while SBP increased by (2 - 11) mm Hg and (6 - 8) mm Hg in average for men and women, respectively in reference groups, and DBP increased by (2 - 6) mm Hg in average for men in five of eight reference groups, and by (3 - 6) mm Hg for women in four of eight reference groups. Serum level of cholesterol decreased by 0.26 mmol/L in women and slightly increased for men at CISC, and increased by (0.35 - 0.97) mmol/L for men and (0.29 - 1.05) mmol/L for women in all reference groups. Prevalence of overweight increased by 58.7% for men and 11.3% for women at CISC and increased by one to 22 folds in eight reference groups. Awareness of health knowledge improved significantly with an average net reduction of SBP/DBP of (2.5/2.2) mm Hg in the enforced intervention group at CISC than that in general intervention groups. Incidence and mortality rates of stroke decreased by 54.7% and 74.3%, respectively in intervention group at CSIC, but those of coronary events slowly increased with fluctuation., Conclusion: Worksite-based comprehensive intervention for CVD prevention and control was feasible and cost-effective in decreasing risk factors for CVD, incidence and mortality rate of stroke in population of urban areas of China.

Objective: To study the ratio of ischemic to hemorrhagic stroke incidence in Chinese populations., Methods: Fifteen populations in China, each including about 100,000 residents, were monitored from 1991 to 2000 for the occurrence of stroke. Stroke was classified as hemorrhagic, ischemic and unclassified based on the clinical data and CT scan results respectively., Results: The average CT scan rate in stroke patients from 1996 to 2000 varied from 14.8% to 97.5% among the 15 population and the average ratio of ischemic to hemorrhagic stroke ranged from 0.23:1 to 4.38:1; the correlation coefficient between the ratio and CT scan rate is 0.7 (P = 0.003). In all the populations with CT scan rate greater than 80%, the ischemic to haemorrhagic ratios were all greater than 1.0. From 1991 to 2000 in 12 populations with complete data, the CT scan rate in stroke patients rose from 41.1% to 88.3% and the ischemic to hemorrhagic ratio rose from 1.25:1 to 1.85:1. The correlation coefficient between the ratio and the CT scan rate was 0.9 (P < 0.001). In patients having CT scan, the ischemic to hemorrhagic ratio was greater than 1.0 in all the years., Conclusion: The predominant type of stroke in Chinese population is ischemic. The low CT scan rate in some populations is the main reason for the false impression predominantly hemorrhagic stroke.

Objective: To evaluate the necessity, scientificity, and feasibility of the drafted Practice Guidelines on Prevention and Treatment of Hypertension for Primary Care Physicians., Methods: Derivative Dolphe Method was used to collect the responses from 50 experts in hypertension or related fields within the nation. An evaluation score of 1 to 5 was given to each item for selection, 1 for highly disagreed and 5 for highly agreed. The mean, standard deviation (SD) and coefficient of variance (CV) of the scores were calculated., Results: (1) 90% experts responded to the evaluation sheet. (2) The mean score were above 4 for the five out of the six items related to necessity, the SD varied from 0.51 to 1.05, and the CV from 0.11 to 0.30. (3) Among the 28 items related to scientificity and rationality, the mean score was above 4 for 25 items and was between 3.5 and 4 for other three items. The CV was generally lower than 0.35. (4) Among the seven items related to feasibility, the mean score for five of them was lower than 4, and the CV varied from 0.21 to 0.33., Conclusion: The results indicate that the necessity and scientificity of the most content of the guidelines are confirmed by the invited experts.

Objective: To study the inter-population and inter-individual effect of education attainment on men's behavior of smoking in China., Method: A cross-sectional study of 7,415 men, aged 35-59 years, from 15 population samples was carried out in 1998. Information on education attainment and smoking was collected by standardized questionnaires. The population samples were divided into 2 groups according to the proportion of men with college or above education attainment: group I had an average 25.8% of men with college or above education attainment, and group II had an average 2.0% of men with college or above education attainment., Results: (1) In group I, the percent of ever smokers, current smokers, deeper smoker, and ever smokers with cessation due to disease and the average number of cigarettes per day for the smokers were significantly lower than in group II (66.2%, 56.4%, 34.4%, 47.8%, 17.2 cigarettes/day vs 75.8%, 64.4%, 40.3%, 58.4%, 20.4 cigarettes/day, respectively). (2) The percent of current smokers and the number of cigarettes decreased with increased education attainment in both groups. Taking the men with college or above education attainment in group I as reference, the odd ratio of smoking for those with high school education in group I was 1.8 (95% CI: 1.5-2.1), for those with middle school or lower education in group I was 2.0(95% CI: 1.7-2.5), for those with college or above education in group II was 1.4(95% CI: 0.9-2.1), for those with high school education in group II was 1.7(95% CI: 1.4-2.1), and for those with middle school or lower education in group II was 2.4 (95% CI: 2.1-2.8)., Conclusion: Smoking behavior was affected by both individual education attainment and population education level. Smoking cessation measures should be focused on the development of better anti-smoking environment, such as education development, health promotion, etc.