Menotti A
Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanita, Rome, Italy.
Int J Epidemiol. 1989;18(3 Suppl 1):S125-8.
Death rates from coronary heart disease (CHD) were rising in Italy until the mid-1970s, and then a decline occurred until the early 1980s (-16% in men, -27.1% in women). The increasing trends in CHD mortality following World War II can be explained by changes in the diet, traditionally poor in animal fats and rich in carbohydrates, towards more Westernized eating habits and by the documented increase in mean serum cholesterol. The recent decline in CHD mortality is partly explained (theoretically, about 60%) by the decrease in the estimated coronary risk, as measured in national samples (-10% in males and -13% in females). There have been slight decreases in smoking habits in men, in body weight in women, and in blood pressure in both sexes, largely related to better control of hypertension. Some indirect documentation suggests there has also been a favourable influence of improved medical care.
直到20世纪70年代中期,意大利冠心病(CHD)死亡率一直在上升,随后出现下降,直至80年代初(男性下降16%,女性下降27.1%)。二战后冠心病死亡率上升趋势可以用饮食变化来解释,传统饮食中动物脂肪含量低、碳水化合物含量高,后来饮食习惯变得更加西化,同时有记录显示平均血清胆固醇有所增加。近期冠心病死亡率下降部分原因(理论上约60%)是估计的冠心病风险降低,这在全国样本中有所体现(男性降低10%,女性降低13%)。男性吸烟习惯略有下降,女性体重有所减轻,男女血压均有所下降,这在很大程度上与高血压得到更好控制有关。一些间接证据表明,医疗保健改善也产生了有利影响。