Authors

• Ivona Brajković — Klinika za liječenje, prevenciju i rehabilitaciju bolesti srca i krvnih žila Thalassotherapia Opatija, Opatija, Hrvatska — ORCID: 0000-0002-1420-5918
• Viktor Peršić — Klinika za liječenje, prevenciju i rehabilitaciju bolesti srca i krvnih žila Thalassotherapia Opatija, Opatija, Hrvatska — ORCID: 0000-0003-4473-5431
• Irena Kužet Mioković — Klinika za liječenje, prevenciju i rehabilitaciju bolesti srca i krvnih žila Thalassotherapia Opatija, Opatija, Hrvatska — ORCID: 0000-0003-4990-6201
• Marica Komosar Cvetković — Klinika za liječenje, prevenciju i rehabilitaciju bolesti srca i krvnih žila Thalassotherapia Opatija, Opatija, Hrvatska — ORCID: 0000-0002-9539-9733
• Paolo Šorić — Klinika za liječenje, prevenciju i rehabilitaciju bolesti srca i krvnih žila Thalassotherapia Opatija, Opatija, Hrvatska — ORCID: 0000-0001-5344-5052

Abstract

In early 1970s mortality rate from cardiovascular diseases (CVD) was highest in Finland, especially in Finnish province North Karelia. (1) With cooperation and support from World Health Organization (WHO) in 1972. began a North Karelia project with main goals as follows: mortality reductions from CVD and other chronic, non-infectious disease, and promotions of healthy lifestyles. (2) Pilot project lasted for 5 years and it had achieved impressive results and became a demonstration model for promotion of a healthy way of living. Primary end-point was achieved with reductions of mortality rate from CVD in North Karelia province by 85% in 35 years. Main risk factors associated with unhealthy living style in North Karelia were physical inactivity, smoking and unhealthy diet which was rich in saturated fats. Integrated approach to prevention was the main core of the project and it led to achievement of general goal and health improvement. Project success was achieved with appropriate epidemiological and behavioral framework with limited and well-defined goals, flexible interventions, close collaboration with community associated with positive feedback, collaboration with media, international collaboration, WHO support and long-term and dedicated leadership. Universal, determined program that is theory-based can have positive impact on risk factors and life-style changes. These life-style modifications are associated with positive changes in chronic diseases and overall health of population. Big national program can be a strong tool for favorable national development in prevention of chronic diseases and health promotion. If we look at this project, we can produce new perspectives for structural, stratified and relevant approach to health care which relies on personalized medicine, and which incorporate predictive, preventive, personalized and participatory access to each individual.

Keywords

North Karelia project, secondary prevention, personalized medicine

DOI

Literature

1. Laatikainen T, Critchley J, Vartiainen E, Salomaa V, Ketonen M, Capewell S. Explaining the decline in coronary heart disease mortality in Finland between 1982 and 1997. Am J Epidemiol. 2005 Oct 15;162(8):764–73. https://doi.org/10.1093/aje/kwi274
2. Puska P. Successful prevention of non-communicable diseases: 25 year experiences with North Karelia Project in Finland. Public Health Medicine 2002; 4(1):5-7. Available from: (October 10, 2018). https://www.who.int/chp/media/en/north_karelia_successful_ncd_prevention.pdf