title: Distribution of short and lifetime risks for cardiovascular disease in Italians.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional general population-based cohort study.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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. dicastel@ngi.it
authors.forename: Augusto
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: Simona
authors.initials: S
authors.lastname: Costanzo
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Persichillo
authors.forename: Marco
authors.initials: M
authors.lastname: Olivieri
authors.forename: Amalia
authors.initials: A
authors.lastname: de Curtis
authors.forename: Francesco
authors.initials: F
authors.lastname: Zito
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors