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Diego Vanuzzo

Publications and source records attributed to Diego Vanuzzo.

27 records · Page 2Linked to original sources
PubMed2004

[Evaluation of the global cardiovascular absolute risk: the Progetto CUORE individual score].

To identify individuals at high risk for cardiovascular disease, the function of the Progetto CUORE has been identified and the global cardiovascular risk score has been built using data from different cohorts enrolled in the North, Center and South of Italy between the 80s and the 90s, whose risk factors had been collected using standardised procedures. A follow-up with a median duration of 9.5 years for men and 8.0 years for women has been achieved. Age, systolic blood pressure, total cholesterol, HDL-cholesterol, smoking habit, diabetes and hypertension treatment have been included in the function; the first major coronary or cerebrovascular event was considered as endpoint; 10-year survival has been assessed both for men and women. Out of 20 647 people aged 35-69 years with no previous cardiovascular events, 971 major cardiovascular events (636 coronary and 335 cerebrovascular) have been identified and validated. Risk factors coefficients have been assessed using the Cox proportional hazard model separately for men and women. The individual score is easy to be applied by general practitioners and cardiologists in order to achieve a fast and objective evaluation of the absolute global cardiovascular risk in primary prevention.

Adult↗
PubMed2003

Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States.

CONTEXT: Geographic variations in cardiovascular disease (CVD) and associated risk factors have been recognized worldwide. However, little attention has been directed to potential differences in hypertension between Europe and North America. OBJECTIVE: To determine whether higher blood pressure (BP) levels and hypertension are more prevalent in Europe than in the United States and Canada. DESIGN, SETTING, AND PARTICIPANTS: Sample surveys that were national in scope and conducted in the 1990s were identified in Germany, Finland, Sweden, England, Spain, Italy, Canada, and the United States. Collaborating investigators provided tabular data in a consistent format by age and sex for persons at least 35 years of age. Population registries were the main basis for sampling. Survey sizes ranged from 1800 to 23 100, with response rates of 61% to 87.5%. The data were analyzed to provide age-specific and age-adjusted estimates of BP and hypertension prevalence by country and region (eg, European vs North American). MAIN OUTCOME MEASURES: Blood pressure levels and prevalence of hypertension in Europe, the United States, and Canada. RESULTS: Average BP was 136/83 mm Hg in the European countries and 127/77 mm Hg in Canada and the United States among men and women combined who were 35 to 74 years of age. This difference already existed among younger persons (35-39 years) in whom treatment was uncommon (ie, 124/78 mm Hg and 115/75 mm Hg, respectively), and the slope with age was steeper in the European countries. For all age groups, BP measurements were lowest in the United States and highest in Germany. The age- and sex-adjusted prevalence of hypertension was 28% in the North American countries and 44% in the European countries at the 140/90 mm Hg threshold. The findings for men and women by region were similar. Hypertension prevalence was strongly correlated with stroke mortality (r = 0.78) and more modestly with total CVD (r = 0.44). CONCLUSIONS: Despite extensive research on geographic patterns of CVD, the 60% higher prevalence of hypertension in Europe compared with the United States and Canada has not been generally appreciated. The implication of this finding for national prevention strategies should be vigorously explored.

Adult↗
PubMed2003

Trends in stroke and coronary heart disease in the WHO MONICA Project.

BACKGROUND AND PURPOSE: Coronary heart disease (CHD) and stroke are leading causes of death and disability. Because they share major common risk factors, it would be expected that trends in mortality and incidence of these 2 major cardiovascular diseases would be similar. METHODS: Data from the World Health Organization (WHO) Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project were used to compare 10-year trends in mortality, event rates, and case fatality from both CHD and stroke. Fifteen populations in the WHO MONICA Project provided data on both CHD (60 763 events) and stroke (10 442 events) in men and women aged 35 to 64 years (23.4 million person-years of observation in total). RESULTS: Trends for the 2 cardiovascular diseases varied within and between populations, and when data from all populations were combined, trends in CHD and stroke mortality differed in men (P=0.001) but not in women, whereas trends in event rates differed significantly in both men and women (P<0.001 and P=0.011, respectively). The differences in trends for CHD and stroke case fatality were not statistically significant in either men or women. In sensitivity analyses, differences in trends in event rates remained statistically significant in men (P<0.001) but not in women. CONCLUSIONS: Trends for CHD and stroke mortality rates, event rates, and case fatality differ substantially between and within the study populations.

Adult↗
PubMed2003

Hypertrophy at ECG and its regression during treatment survey (HEART survey). Rationale, design and baseline characteristics of patients.

BACKGROUND: Left ventricular hypertrophy (LVH) detected at electrocardiography (ECG) is a predictor of an increased cardiovascular risk in essential hypertension. However, uncertainty remains concerning the reproducibility of ECG LVH and the prognostic relevance of its regression over time in hypertension. The aim of this study was to determine the prognostic value of baseline ECG LVH and its serial changes in a large cohort of hypertensive patients. METHODS: The Hypertrophy at ECG and its Regression during Treatment Survey (HEART Survey) is a prospective observational study conducted in 66 Italian centers. Inclusion criteria are essential hypertension with ECG LVH defined by the Perugia score (Cornell voltage criteria and/or a typical left ventricular "strain" pattern and/or a Romhilt-Estes score > or = 5 points) in subjects aged 45-84 years. The treatment of hypertension and other risk factors accords with current guidelines and is individually tailored. ECG is recorded twice at entry and periodically repeated over a 4-year follow-up period. Expert readers (unaware of the clinical findings) classify ECG. The incidence of major cardiovascular events in relation to baseline ECG and its changes over time are assessed, together with the reproducibility in the two baseline recordings. Overall, 708 patients aged 64 +/- 9 years have been enrolled in centers from northern (27%), central (32%) and southern (41%) Italy. Their baseline characteristics are presented. Follow-up is ongoing. CONCLUSIONS: The HEART Survey will examine the prognostic value of baseline ECG LVH and of its regression over time in a wide population of hypertensive patients.

Aged↗
PubMed2003

The San Daniele 2 Project: protocol description and population characteristics.

In 1990 we studied the prevalence and determinants of carotid atherosclerosis in an Italian general asymptomatic population (630 males and 718 females aged 18-99 years) living in the San Daniele district of the Friuli-Venezia Giulia Region. The global prevalence of subclinical carotid atherosclerosis was 25.4% in men and 26.4% in women. We considered intima-media thickness, non-stenotic plaque (< 40%), and stenotic plaque (> 40%). In the multiple logistic regression, the cross-sectional analysis of subjects aged 40 years showed a positive significant association between plaques/stenosis and age (p < 0.001), systolic blood pressure (p < 0.01), cigarette smoking (p < 0.0001), and the protective effect of high-density lipoprotein cholesterol (p < 0.037). In 2002 we decided to re-examine the initial cohort with the following objectives: prospectively evaluating the modifications of the previous carotid findings, their relationship with known and less documented cardiovascular risk factors and the predictive power of those variations on incident coronary and cerebrovascular events. We plan to evaluate the association of carotid plaque and carotid intima-media thickness with the genetic polymorphisms involved in atherosclerosis in survivors and finally to study the incidence and the determinants of atrial fibrillation in a general population. In this paper, we will describe the methodology of the screening and the cohort population characteristics. We have compared the San Daniele Project survivor cohort's characteristics to the current general population of the same age living in the Friuli-Venezia Giulia Region so as to extend the study's conclusions to the whole regional population.

Adolescent↗
PubMed2002

Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? Comparisons of 15 populations in 9 countries within the WHO MONICA Stroke Project. World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease.

BACKGROUND AND PURPOSE: Previous studies have indicated a reasonably strong relationship between secular trends in classic cardiovascular risk factors and stroke incidence within single populations. To what extent variations in stroke trends between populations can be attributed to differences in classic cardiovascular risk factor trends is unknown. METHODS: In the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease (WHO MONICA) Project, repeated population surveys of cardiovascular risk factors and continuous monitoring of stroke events have been conducted in 35- to 64-year-old people over a 7- to 13-year period in 15 populations in 9 countries. Stroke trends were compared with trends in individual risk factors and their combinations. A 3- to 4-year time lag between changes in risk factors and change in stroke rates was considered. RESULTS: Population-level trends in systolic blood pressure showed a strong association with stroke event trends in women, but there was no association in men. In women, 38% of the variation in stroke event trends was explained by changes in systolic blood pressure when the 3- to 4-year time lag was taken into account. Combining trends in systolic blood pressure, daily cigarette smoking, serum cholesterol, and body mass index into a risk score explained only a small fraction of the variation in stroke event trends. CONCLUSIONS: In this study, it appears that variations in stroke trends between populations can be explained only in part by changes in classic cardiovascular risk factors. The associations between risk factor trends and stroke trends are stronger for women than for men.

Adult↗