Blood lipids in Italy. Regional differences.

Serum cholesterol and triglyceride levels have been evaluated in samples from fasting males aged 20--59 in Northern (Brisighella), Central (Rome) and Southern (Pozzuoli) Italy. Regularly performed quality controls between laboratories assured comparability of data. A statisitically significant difference of mean serum cholesterol and triglyceride levels was observed for most age-groups in the 3 different areas, lower values being found in the southern population as compared to the central and northern ones. These results support previous findings and the thesis that large differences in blood lipid levels may still exist even within the same country and that they at least in part may be culturally determined in connection with different dietary habits.

Change in cardiovascular risk factors during a 10-year community intervention program.

The study describes changes in cardiovascular risk factors during 10 years of a community intervention program conducted in a rural area in Central Italy. Two areas were involved, one for treatment and one for reference. In 1983-84, 739 men and 859 women in the treatment area and 942 men and 1045 women in the control area, aged 20-69 years, were screened; total and HDL cholesterol, systolic and diastolic blood pressure, fasting blood glucose, smoking habit, weight and height were measured. Between 1983 and 1993 several intervention activities based on community medicine were carried out in the treatment area. They were based on interaction with the local socio-sanitary institutions and school system in order to influence individual persons, small groups and entire community. Major effort was addressed to mass health education, nutrition education, antismoking-propaganda and detection and treatment of hypertension, diabetes and hyperlipidemia.

[Respiratory function and cardiovascular risk factors. Research Group for the Integrated Community Control of Chronic-degenerative diseases in the Health District of Sezze -- Di.S.Co. -- Observational strategy to assess the community health status]. / Funzionalità respiratoria e fattori di rischio cardiovascolare. Gruppo di Ricerca Controllo Communitario Integrato nelle Malattie Cronico-degenerative nel Distretto Sanitario di Sezze--Di.S.Co.--Strategie osservazionali per la valutazione della salute nella comunità.

Within the Project Community Control of Chronic Diseases in the Health District of Sezze-Di.S.Co.-2940 men, aged 20-69 were examined between 1984 and 1987, and a pulmonary function test was performed together with the measurement of a number of cardiovascular risk factors. Blood tests, blood pressure, anthropometric measurements, ECG, spirometry and a questionnaire on life-style and diseases were available. The aim of this paper was to describe pulmonary function tests and to study their association with cardiovascular risk factors. Vital capacity (CV) and forced expiratory volume in one second (VEMS), adjusted by height were inversely related with age. Main cardiovascular risk factors were analysed in tertiles of CV and VEMS: fasting blood glucose, serum cholesterol, uric acid, haematocrit, diastolic blood pressure, number of cigarettes per day decreased going from the first to the third tertile, whilst HLD-cholesterol and alcohol consumption increased. Univariate and multivariate analysis showed an inverse relation of CV and VEMS with age, fasting blood glucose, number of cigarettes smoked per day, uric acid, heart rate, skinfold thickness whilst alcohol consumption and weight were inversely related. The models explained between 52% (VC) to 57% (VEMS) of the variance.

[Community prevention: the role of women]. / La prevenzione in comunità: il ruolo della donna.

Socio-cultural, biological, psychological and environmental determinants of health develop within the community. Therefore, any intervention aimed at promoting health must derive from and evolve within the community itself, with the participation of all its members, each of whom charged with a specific and well-defined role to play. Deep changes have occurred in modern society, as a consequence of industrialization and urbanization. This notwithstanding, the biological and social role of women in family management has remained unchanged, even after the spreading of female work. The community-based control of chronic and degenerative diseases calls for the acquirement of a lifestyle more suitable to maintaining health. To this purpose, women can be charged with the responsibility of carrying our activities aimed at improving scientific knowledge to the benefit of the whole community.

Short term changes in cardiovascular risk factors in the Di.S.Co. Intervention Project. Research Group of the DI.S.Co. Project.

The Di.S.Co. Project--Sezze District Community Control--is aimed at achieving in the general population the prevention of chronic diseases through community intervention. Two areas are enrolled, one for intervention (25,706 subjects) and one for reference (12,655 subjects). In 1983 the first survey was conducted on a sample of males and females aged 20-69, and some risk factors for cardiovascular diseases were measured. In 1986 a second screening was conducted on the same sample examined in 1983 and in a new one to evaluate the effect of community treatment during the three-year intervention. The main net differences obtained in the treatment area against controls (by the paired analysis), adjusted by the initial levels of the risk factors considered, were: in males body mass index: -1.3% and number of cigarettes smoked per day: -5.1%; in females systolic blood pressure: -2.1%, body mass index: -3.2% and number of cigarettes smoked per day: -34.4%. The theoretical probability of death from atherosclerotic cardiovascular diseases in 25 years was estimated by the multiple logistic function and in three years it increased by 1% in males, while for females it decreased by 6.5%.

[Various comparative data on the distribution of arterial pressure and on the prevalence of arterial hypertension in samples of the Italian population]. / Alcuni aspetti comparativi sulla distribuzione della pressione arteriosa e sulla prevalenza dell'ipertensione arteriosa in campioni di popolazione italiana

After a foreword concerning the present interest for the epidemiology of arterial hypertension mainly in relationship with the prevalence of the condition, its recognition in the general population and its systematic treatment, three separate chapters show the distribution of arterial blood pressure, its mean values and the prevalence of hypertension collected by three research groups: the Centre for Cardiovascular Diseases, St. Camillo Hospital, Rome, with 8 population groups (6929 subjects of whom 447 women, aged 20 to 64, belonging to the city of Rome and to other locations of 5 different regions); the II Medical Clinic, University of Padua, with 2 population groups (5852 men and women aged 20-64, belonging to a defined area of Veneto); the Research Group of the Roman Project of Coronary Heart Disease Prevention, with 2 population groups (2611 men aged 40-59, from Rome). The data provide a description of some characteristics of blood pressure and hypertension in different Italian areas and population groups and show the existence of large differences in the mean values of blood pressure and in the prevalence of hypertension, also within the country.

Cholesterol levels in Italian school children: results of an opportunistic survey.

BACKGROUND AND AIMS: A high prevalence of elevated serum total cholesterol (TC) levels has been described among Italian children. Universal screenings for TC have been suggested, though present recommendations are in favour of more selective and opportunistic surveys. Aim of the study was to assess TC distribution among 13-year-old schoolchildren in Central Italy. Further aim was to evaluate the indications for universal, selective or opportunistic screenings for TC. METHODS AND RESULTS: Children were examined opportunistically within a permanent screening programme for Mediterranean anemia carried out in the Lazio Region. TC was measured by dry chemistry in 3734 boys and 3644 girls aged 13 years from 77 schools in 37 municipalities. Results were grouped for 8 geographically and demographically similar areas. Mean TC was 137.6 mg/dl in boys and 144.3 mg/dl in girls. Desirable levels (< 170 mg/dl) were observed in about 90% of the children and fewer than 2% displayed levels indicative of genetic hypercholesterolemia (> 200 mg/dl). However, in two areas mainly populated by descendants from Northern Italy mean TC was remarkably high (158.7 and 152.2 mg/dl in boys and 164.5 and 160.0 in girls) and the percentage with desirable levels dropped to 68.6% and 74.7%. CONCLUSIONS: Our results show average good TC levels among Italian schoolchildren in Central Italy. This is probably due to their traditional Mediterranean diet. It can thus be suggested that only selective and/or opportunistic screenings for TC are indicated. However, in some areas where fewer children have desirable levels and almost 30% require dietary education, large-scale screenings are highly recommended.

Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO).

AIMS: To investigate the incidence, risk factors and natural history of gallstone disease, a random sample of females belonging to a rural population was enrolled in a ten-year longitudinal study. METHODS: The study has been performed in a small town on the hills south of Rome. In 1985, a random sample of 426 females, aged 20-69 years, was screened by real-time ultrasonography for gallstones and previous cholecystectomy. Screening methods included anthropometry, collection of a blood sample and a questionnaire on the occurrence of abdominal symptoms. During 1995, all these subjects were invited for a 10-year follow-up examination. RESULTS: The overall 10-year incidence of gallstone disease was 6.3% (5.5% of new gallstones and 0.8% of cholecystectomies). Only 23.1% of the women with gallstones were aware of their condition. More than three quarters (76.9%) had not suffered biliary pain. Univariate and multivariate analyses demonstrated a positive independent association of new gallstone disease with body mass index and parity. Out of the initially asymptomatic gallstone women, 15.4% experienced at least one episode of biliary pain, 23.1% were submitted to elective cholecystectomy and 61.5% remained asymptomatic. CONCLUSIONS: The study demonstrates a high incidence of gallstone disease in women belonging to a rural free-living population in Italy and suggests body mass index and parity as possible true risk factors. Moreover, it confirms that a remarkable proportion of asymptomatic patients become symptomatic and eventually undergo cholecystectomy.