Impact of a Community-Based Multiple Risk Factor Intervention on Cardiovascular Risk in Black Families With a History of Premature Coronary Disease

Abstract

Background— Black subjects with a family history of premature coronary heart disease (CHD) have a marked excess risk, yet barriers prevent effective risk reduction. We tested a community-based multiple risk factor intervention (community-based care [CBC]) and compared it with “enhanced” primary care (EPC) to reduce CHD risk in high-risk black families. Methods and Results— Black 30- to 59-year-old siblings of a proband with CHD aged P Conclusions— Eliminating known barriers may not be sufficient to reduce CHD risk in primary care settings. An alternative community care model that addresses barriers may be a more effective way to ameliorate CHD risk in high-risk black families.