Why Did North Karelia-Finland Work?

Successful prevention of cardiovascular diseases in the North Karelia Project and Finland has drawn international attention, particularly as cardiovascular diseases and more generally noncommunicable diseases have become the leading cause of premature mortality in the world. The questions have often been asked about what were the main reasons for success and whether or not the experience could be transferred elsewhere. The main lesson is that the possibilities and potential of cardiovascular prevention are great. The principles of population-based prevention are universal and are expressed in the strategies of World Health Organization. But, the practical implementation of the preventive work must be tailored to local cultural, social, and administrative (political) situations. This paper discusses many elements of the work in North Karelia and Finland that were likely important for success.