Open Access Open Badges Research article

Evaluation of a community intervention program in Japan using Framingham risk score and estimated 10-year coronary heart disease risk as outcome variables: a non-randomized controlled trial

Bing Zhu13, Yasuo Haruyama1*, Takashi Muto1, Akiko Yamasaki2 and Fumiko Tarumi2

Author Affiliations

1 Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan

2 Soka City Health Center, Soka, Saitama, Japan

3 Division of Health Education, Anhui Provincial Center for Disease Control and Prevention, Hefei, China

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BMC Public Health 2013, 13:219  doi:10.1186/1471-2458-13-219

Published: 11 March 2013



Community-based programs are being widely adopted in the struggle to prevent cardiovascular diseases. No study has been conducted in Japan to evaluate the effects of a community-based health promotion program by using the Framingham risk score and 10-year CHD risk as outcome variables. The aim of the present study was to assess the effects of a program involving 6-month intervention and 18-month follow-up using such outcomes.


Participants (n = 1,983, 39.5% women, mean age 63.4 years) were selected for the study in 2008. Of these 1,983, 347 (42.4% women) subjects received the 6-month intervention. The intervention included individual counseling and group sessions, among others. After 18 months, 1,278 participants (intervention group: 238, control group: 1,040) were followed up. Changes in the Framingham risk score and 10-year coronary heart disease (CHD) risk were evaluated. ANCOVA and multiple logistic models adjusted for baseline value, age, sex and intervention times were used.


The results showed that the differences in the Framingham risk score and mean 10-year CHD risk were significant in the intervention group compared with the control group after 6-month follow-up (-0.46 and -1.12, respectively) and were also significant after 18-month follow-up (-0.39 and -0.85, respectively). The proportion of those with intermediate 10-year CHD risk (> = 10%) was significantly lower at 6 months (OR 0.30, 95% CI 0.12-0.74) and at 18 months (OR 0.41, 95% CI 0.19-0.92).


The six-month intervention program effectively decreased estimated 10-year CHD risk and the effects were still present at 18-month follow-up.

Trial registration

UMIN-CTR: UMIN000008163

Coronary disease; Lifestyle; Prevention; Risk factors