title: Prevalence of 'borderline' values of cardiovascular risk factors in the clinical practice of general medicine in Italy: results of the BORDERLINE study.
abstract: BACKGROUND
  The prevalence of patients with 'borderline' levels of cardiovascular risk factors has been rarely investigated, being often reported in studies evaluating abnormal values of these parameters. The BORDERLINE study represents a pilot experience to primarily identify the prevalence of 'high-normal' conditions, such as pre-hypertension, lipid and glucose levels in the upper range of normality in the setting of general practice in Italy.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the prevalence of patients with 'borderline' values of cardiovascular risk factors in Italy.
  
  
  METHODS
  Involved physicians were asked to evaluate the first 20 outpatients, consecutively seen in June 2009. Data were collected in a study-designed case-report form, in which physicians identified thresholds rather than reported absolute values of several clinical parameters. High-normal values were defined as follows: blood pressure (BP) 130-140/85-90 mmHg; total cholesterol 180-200 mg/dL; low-density lipoprotein cholesterol (LDL-C) 130-150 mg/dL; high-density lipoprotein cholesterol (HDL-C) 30-40 mg/dL in males and 40-50 mg/dL in females; triglycerides 130-150 mg/dL and fasting glucose 100-110 mg/dL.
  
  
  RESULTS
  Fifty-three Italian physicians provided valuable clinical data on 826 individual outpatients, among which 692 (83.7%, 377 women, mean age 60.9 ± 13.2 years, body mass index 26.6 ± 5.0 kg/m2) were included in the present analysis. Prevalence of borderline values of systolic BP and total cholesterol levels were at least comparable with those in the normal limits of the corresponding parameters, whereas prevalence of borderline diastolic BP, LDL-C, HDL-C, triglycerides and fasting glucose levels was significantly lower than that of normal values, but higher than that of abnormal values of the corresponding parameters.
  
  
  CONCLUSIONS
  Using this sample of healthy subjects in the setting of general practice in Italy, our results demonstrated a relatively high prevalence of borderline values of cardiovascular risk factors, which was at least comparable with that of normal, but significantly higher than that of abnormal thresholds. These preliminary findings may prompt more extensive investigations in the area of 'borderline' cardiovascular risk. This information may, in fact, potentially enable the design of more effective prevention strategies in the future to limit the burden of cardiovascular disease in the general population in Italy. Received for publication 4 March 2011; accepted for publication 20 April 2011.
authors.affiliation: Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant' Andrea Hospital, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Tocci
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrucci
authors.forename: Jasmine
authors.initials: J
authors.lastname: Passerini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Averna
authors.forename: Paolo
authors.initials: P
authors.lastname: Bellotti
authors.forename: Graziella
authors.initials: G
authors.lastname: Bruno
authors.forename: Francesco
authors.initials: F
authors.lastname: Cosentino
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
authors.forename: Giulio
authors.initials: G
authors.lastname: Nati
authors.forename: Antonio
authors.initials: A
authors.lastname: Tiengo
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Diego
authors.initials: D
authors.lastname: Vanuzzo
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D058246:Prehypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids