Risk factors for cardiovascular disease in Sardinia from 1978 to 2001: A comparative study with Italian mainland

Abstract 

Background

This study is a survey of cardiovascular risk factors in Sardinia in the years 1999–2001 and allows us to update previously observed trends of such factors and to compare them with those in the Italian mainland.

Methods

Random samples of free living population of the Mediterranean island of Sardinia, Italy, were collected. Overall, 6818 subjects, 50% of each sex, and aged 20–80+ years constituted the sample. Personal and family data were collected using a semiquantitative questionnaire of frequencies. Blood biochemical variables related to risk for atherosclerosis were measured. In particular, serum total cholesterol, HDL-cholesterol, triglycerides, Apo A-1, Apo B, Lp(a), uric acid, blood glucose and plasma homocysteine were analyzed in each subject enrolled.

Results

In the age classes 20–59 years, during a 30 year period, prevalence of smoking among males continued to decrease from 58 to 24% (p for trend <0.001), and, for the first time, prevalence of smoking among females decreased as well: from 31% in 1995 to 20% in 2001 (p for trend <0.001). In contrast, a steady increase in TC (mg/dl) (189, 206, 215, 216, p for trend <0.05 in males and 184 197, 212, 217, p for trend <0.05 in females), and LDL-C (136, 143, 138, 144, p for tend <0.05 in males and 127, 139, 136, 135, p for trend <0.05 in females) was observed. HDL-C showed a steady increase (p for trend <0.01 in males and females). Lp(a) values were high in both sexes, a finding linked to the ethnic influence on them. Systolic and diastolic blood pressure values (mm Hg) increased with age. In the present survey (population aged 20–80+ years, current smokers were 17.5% among males and 13.8% among females. Total and HDL-cholesterol were higher than in other parts of Italy (209 vs 205 in males, and 211 vs 204 in females), while systolic and diastolic blood pressure were lower.

Conclusion

Overall, total- and LDL-cholesterol showed an increasing trend, while blood pressure and smoking habits had a decreasing tendency. The increase in blood cholesterol follows the trend in other areas of the world, mainly due to changing dietary habits. Therefore, a campaign of eating information and education (population strategy) could favourably modify cardiovascular risk, as occurred in Sardinia during the past decade with the Regional ATS-Sardegna Campaign.

Abbreviations: Apo A-1, Apolipoprotein A-1, Apo B, Apolipoprotein B, BMI, Body mass index, CVD, Cardiovascular disease, Diast, Diastolic blood pressure, G, Blood glucose, H, Hip circumference, HCY, Homocysteine, HDL-C, High-density lipoprotein cholesterol, LDL-C, Low-density lipoprotein cholesterol, Lp(a), Lipoprotein(a), Syst, Systolic blood pressure, TC, Total cholesterol, TG, Triglycerides, WC, Waist circumference, W/H, Waist/Hip ratio, 80+, 80 years of age and over

Keywords: Cardiovascular risk factors, Epidemiology, Italy, Sardinia, Survey