[Cardiovascular Risk Assessment: preliminary results].
BACKGROUND
The Italian National Prevention plan includes 10-year cardiovascular risk (CR) assessment of the Italian general population aged 35-69 years using the CUORE Project risk score. A national training program for general practitioners (GPs) was launched by the Ministry of Health in 2003. GPs were encouraged to collect data on risk factors and risk assessment and to contribute to the CUORE Project Cardiovascular Risk Observatory (CRO). The aim of this analysis is to demonstrate the feasibility and effectiveness of risk assessment in primary care.


METHODS
The cuore.exe software, free of charge for GPs and easily downloadable from the CUORE Project web site (www.cuore.iss.it), is the frame for the GP data collection. The CRO provides a platform to analyze data collected on risk assessment and risk factors, and compare results at regional and national level in order to support health policy makers in their decision process.


RESULTS
From January 2007 to April 2009, 2858 GPs have downloaded the cuore.exe software; 102,113 risk assessments were sent to the CRO based on risk factors profile of 87,556 persons (3617 persons had more than 1 risk assessment). Mean level of CR was 3.1% in women and 8.4% in men; 30% of men and 65% of women were at low risk (CR < 3%), 9% of men and 0.4% of women were found at high risk (CR > or = 20%). Among those with at least 2 risk assessments, 8% shifted to a lower class of risk after 1 year. Mean level of systolic and diastolic blood pressure decreased by about 1% in 1 year; total cholesterol more than 2%, and prevalence of smokers decreased by about 3% in the second risk assessment.


CONCLUSIONS
These data demonstrate that risk assessment can be included as a first step of prevention in primary care. The CUORE Project individual score is expected to become an important tool for GPs to assess their patients' CR, to promote primary prevention, and to focus attention to healthy lifestyle adoption.
Palmieri
Luigi
L
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma. luigi.palmieri@iss.it
Rielli
Rita
R
Demattè
Luca
L
Donfrancesco
Chiara
C
La Terza
Giampaolo
G
De Sanctis Caiola
Patrizia
P
Dima
Francesco
F
Lo Noce
Cinzia
C
Giannelli
Anna Maria
AM
Brignoli
Ovidio
O
Cuffari
Alfredo
A
De Rosa
Marisa
M
Addis
Antonio
A
Laurendi
Giovanna
G
Giampaoli
Simona
S
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005194:Family Practice / Q000379:methods / Q000639:trends; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors