الفهرس 
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Abstract
Atherosclerotic cardiovascular diseases (CVDs) are important causes of worldwide preventable morbidity and mortality. Once
considered a problem only in high-income countries, the prevalence of CVD risk factors is dramatically increasing in low- and middle-income countries.
Risk factors for cardiovascular disease may be present decades before clinical disease manifests. Therefore, early identification of patients at risk coupled with provision of optimal risk management is of vital importance in lowering the risk of cardiovascular morbidity and mortality and slowing disease progression.
The Framingham Heart Study is a landmark achievement, well known for its 10-year risk score for prediction of CHD events in asymptomatic patients. Risk factors used in Framingham scoring include age, sex, total cholesterol, high-density lipoprotein cholesterol (HDL-C) blood pressure, and cigarette smoking. Importantly, the FRS is easy to apply and clinically relevant. The FRS for hard CHD events has been incorporated into several guidelines for CVD prevention and been used to guide treatment of risk factors.
The aim of the present study is to assess risk factors for coronary heart disease among attendants to family health center and to study the effect of risk reducing program in lowering the risk for coronary heart disease.
The study was conducted in family health center of Menofia university hospital in Manshat Soultan village. The study included subjects who were above 25 years old and asymptomatic to CHD.
According to FRS, they were classified into low risk, intermediate and high risk group.
All studied subjects received an interventional program to reduce their risk to develop CHD. Only subjects with intermediate and high risk for CHD (87 subjects) were followed up after 6 and 12 month to study the effect of the interventional program.
This study found that 72.9% of the studied population was in the low risk category while 18.7% of them were in the intermediate risk category and only 8.7% of them were in the high risk category. The mean age of the studied group was 50.64 ±10.17.
The prevalence of risk factors for CHD (HTN, DM, high total cholesterol, low HDL-c, smoking, obesity and physical inactivity) were significantly higher among the intermediate and high risk groups for CHD than low risk group.
Six month after implementation of the interventional program 30.1% of the intermediate and high risk group was shifted to the low risk category; the percentage of the subjects in the intermediate risk was decreased from 68.7% to 59%. Also there is a reduction in the percentage of the subjects in the high risk category from 31.3 % to 10.9%. There was a further improvement after 12- month follow up.
There was a significant improvement in the studied risk factors 6-month after the program implementation and this improvement was maintained after 12 month follow up.