[Cardiovascular risk and social classes: a comparison between adult female populations in rural and urban areas]

The distribution of cardiovascular risk factors and the prevalence of several risk conditions are analysed in two female cohorts in southern-central Italy, one living in an urban area (the city of Naples) and the other in a rural area (the province of Latina). Analysis of different social classes identified through the level of education was also performed. The distribution of risk factors is different in the two areas (body mass index, systolic and diastolic blood pressure are higher in the province of Latina, while serum total and HDL cholesterol are higher in Naples) as well as the prevalence of several risk conditions (the prevalence of hypertension is higher in the province of Latina, whereas hypercholesterolemia and smoking are more prevalent in Naples). Cardiovascular risk factors are unevenly distributed in the different social classes: body mass index and systolic and diastolic blood pressure decrease as the educational level increases in both cohorts; in the city of Naples, serum total and HDL cholesterol increase with the increase in educational level. An awareness of these differences is crucial to targeting primary prevention campaigns in specific social classes.

Hand-grip strength predicts incident disability in non-disabled older men

OBJECTIVES

To verify if hand-grip performance in older men is a predictor of disability.

DESIGN

Population-based prospective study.

SETTING

A sample from the Italian rural cohorts of the FINE study (Finland, Italy, Netherlands Elderly), representative of the general population of elderly men surveyed in 1991 and 1995.

PARTICIPANTS

140 men aged 71-91 years who reported no disability in performing activities of daily living (ADLs), instrumental activity of daily living (IADLs) and mobility activities at baseline examination and provided information on their functional status at follow-up 4 years later.

MEASUREMENTS

Disability was defined as needing help in performing ADLs, IADLs and mobility. Hand-grip strength was evaluated at baseline by a mechanical dynamometer.

RESULTS

After adjusting for potential confounding variables, a lower concentration of high-density lipoprotein cholesterol was the only factor predicting disability in men aged 76 years or younger and only reduced hand-grip strength predicted incident disability in men 77 years or older.

CONCLUSION

Poor hand strength as measured by hand-grip is a predictor of disability in older people. The hand-grip test is an easy and inexpensive screening tool to identify elderly people at risk of disability.

Change in cardiovascular risk factors during a 10-year community intervention program

The study describes changes in cardiovascular risk factors during 10 years of a community intervention program conducted in a rural area in Central Italy. Two areas were involved, one for treatment and one for reference. In 1983-84, 739 men and 859 women in the treatment area and 942 men and 1045 women in the control area, aged 20-69 years, were screened; total and HDL cholesterol, systolic and diastolic blood pressure, fasting blood glucose, smoking habit, weight and height were measured. Between 1983 and 1993 several intervention activities based on community medicine were carried out in the treatment area. They were based on interaction with the local socio-sanitary institutions and school system in order to influence individual persons, small groups and entire community. Major effort was addressed to mass health education, nutrition education, antismoking-propaganda and detection and treatment of hypertension, diabetes and hyperlipidemia.

Incidence of major coronary heart disease events: the experience of the Project "Community Control of Chronic Diseases"

Data on incidence of first major coronary heart disease (CHD) event have been collected in a population sample studied in the control area, the municipality of Priverno in Central Italy, 100 km South-East of Rome as part of a Community Control Project of Chronic Diseases run in nearby communities. Men and women aged 40-69 years, examined in population screenings, were followed-up for variable periods of time ranging from 1 month to 11 years, after exclusion of those already carrier of a previous major CHD event. A total of 1427 men and 1675 women corresponding to a maximum of 9590 and 11499 person/years respectively were followed-up. Diagnostic criteria were based on a number of different items including history and ECG data, from screening examinations; discharge records from local hospitals; causes of death from death certificates; and information from mail questionnaires. Four hundred and forty-six men and 501 women were considered partially non respondent since they were examined only once, they did not answer the postal questionnaire, although they were surely alive at the end of the observation period. Incidence estimates were based on different denominators, including or excluding these non respondents. The age adjusted lower incidence estimate was of 40.7 per 10000 person/years among men and 19.7 among women; the higher estimate was of 51.3 and 24.4 per 10000 person/years respectively. Rates were higher among men than among women and were increasing with aging. These incidence rates were slightly lower than those reported from other population studies conducted in Italy in the 1970's and the 1980's, but were in line with the hypothesis of a declining incidence paralleling the decline in CHD mortality. These data, including also estimates in women, represent a reference point for the early 1990's of the frequency and distribution of major CHD events.