Laboratorio di Epidemiologia Genetica e Ambientale, Laboratori di Ricerca, Centro di Ricerche e Formazione ad Alta Tecnologia nelle Scienze Biomediche Giovanni Paolo II, Università Cattolica del Sacro Cuore, Campobasso, Italia.
Eur J Prev Cardiol. 2012 Aug;19(4):723-30. doi: 10.1177/1741826711410820. Epub 2011 May 13.
Guidelines for primary prevention recommend calculation of lifetime risk for cardiovascular disease (CVD) in addition to short-time risk. We aimed at evaluating the distribution of CVD lifetime risk and the percentage of Italians having low short-term, but high lifetime, risk.
Cross-sectional general population-based cohort study.
We included 8,403 (46% men) cardiovascular disease-free individuals aged 35-50 years, among those randomly recruited in the framework of the MOLI-SANI cohort. Participants were stratified into three groups: low short-time (10-year) (≤3% and non diabetic)/low lifetime, low short-time/high lifetime, and high short-time risk. Short-time risk was evaluated by the equation provided by the Italian CUORE project. Lifetime risk was evaluated using the algorithm derived from the Framingham cohort.
High short-time risk was prevalent in 16% population (32% of men and 2% of women). Among individuals with low short-time risk, 80% had high lifetime risk (82% men and 78% women). The proportion of individuals with very low lifetime risk due to all optimal risk factors was 4.1% only (1.5% men and 6.3% women).
A large proportion of Italian adults not qualified for CVD primary prevention because of their very low short-time predicted CVD risk, are in fact at high risk to develop a CVD event in their lifetime; therefore population-based approaches should be sought to modify the overall distribution of individual risk factors. These findings offer helpful information for policy makers involved in contrasting the burden of CVD, especially in women and young men.
除了短期风险外，心血管疾病（CVD）一级预防指南还建议计算终生风险。我们旨在评估 CVD 终生风险的分布以及具有低短期但高终生风险的意大利人的比例。
横断面基于一般人群的队列研究。
我们纳入了 8403 名（46%为男性）无心血管疾病的 35-50 岁个体，这些个体是在 MOLI-SANI 队列研究中随机招募的。参与者分为三组：低短期（10 年）（≤3%且非糖尿病）/低终生，低短期/高终生和高短期风险。短期风险通过意大利 CUORE 项目提供的方程进行评估。终生风险使用Framingham 队列衍生的算法进行评估。
高短期风险在人群中占 16%（男性占 32%，女性占 2%）。在短期风险低的人群中，80%具有高终生风险（男性占 82%，女性占 78%）。由于所有最佳风险因素导致终生风险非常低的个体比例仅为 4.1%（男性占 1.5%，女性占 6.3%）。
由于短期预测 CVD 风险非常低，很大一部分意大利成年人不符合 CVD 一级预防的条件，但实际上他们一生中发生 CVD 事件的风险很高；因此，应寻求基于人群的方法来改变个体风险因素的总体分布。这些发现为参与对抗 CVD 负担的政策制定者提供了有用的信息，特别是在女性和年轻男性中。
