Advertisement

High Blood Pressure & Cardiovascular Prevention

, Volume 25, Issue 3, pp 327–341 | Cite as

Executive Summary of the 2018 Joint Consensus Document on Cardiovascular Disease Prevention in Italy

  • Massimo Volpe
  • Allegra Battistoni
  • Giovanna Gallo
  • Speranza Rubattu
  • Giuliano Tocci
  • the Writing Committee
  • On behalf of the Scientific Societies
Consensus Document

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death, disability and hospitalization in Italy. Primary prevention strategies are able to prevent clinically evident CVDs, mostly by early identifying asymptomatic, otherwise healthy individuals at risk of developing CVDs. A more modern approach recommended for effective CVD prevention is based on “4P”, that is: Predictive, Preventive, Personalized and Participative. This executive document reflects the key points of a consensus paper on CV prevention in Italy, realized though the contribution of different Italian Scientific Societies and the National Research Council, and coordinated by the Italian Society of Cardiovascular Prevention (SIPREC), published in 2018. The need for such document relies on the difficulty to apply “sic et simpliciter” European guidelines, to which this document is largely inspired, to national, regional and local realities, in this Mediterranean country, namely Italy. Indeed, our Country has specific features in terms of demography, socio-cultural habits, distribution and prevalence of risk factors, organization, policy and access to National Health Service compared to other European countries.

Keywords

Cardiovascular prevention Cardiovascular risk factors Cardiovascular mortality Hypertension Dyslipidaemia Diabetes Smoking Obesity Vaccination 

Notes

Acknowledgements

On behalf of the Writing Committee: Domenico Accettura (Bari), Simonetta Bellone (Novara), Paolo Bellotti (Savona),
Marco Bertolotti (Modena), Claudio Borghi (Bologna), Maurizio Casasco (Brescia), Agostino Consoli (Chieti),
 Raffaele Coppini (Firenze), Alberto Corsini (Milano), Gianfranco Costanzo (Roma), Giovambattista Desideri (L’Aquila), Claudio Ferri (L’Aquila), Giorgio Galanti (Firenze), Franco Giada (Venezia), Giancarlo Icardi (Genova), Niccolò Lombardi (Firenze), Maria Grazia Modena (Modena), Pietro Amedeo Modesti (Firenze), Giorgio Monti (Voghera), Alessandro Mugelli (Firenze), Andrea Orsi (Genova), Gianfranco Parati (Milano), Roberto F.E. Pedretti (Pavia),
Gianluca Perseghin (Monza), Matteo Pirro (Perugia), Roberta Ricotti (Novara), Damiano Rizzoni (Brescia),
 Carlo Rotella (Firenze), Guido Salvetti (Pisa), Patrizio Sarto (Treviso), Federico Tassinari (Genova), Bruno Trimarco (Napoli), Saula Vigili de Kreutzenberg (Padova),
 Roberto Volpe (Roma).

On behalf of the Scientific Societies: SIMI, Società Italiana di Medicina Interna; SID Società Italiana di Diabetologia; SIIA, Società Italiana dell’Ipertensione Arteriosa; SISA Società Italiana per lo Studio dell’Aterosclerosi; CNR, Consiglio Nazionale delle Ricerche; FMSI, Federazione Medico Sportiva Italiana; GICR-IACPR, Gruppo Italiano di Cardiologia Riabilitativa e Preventiva - Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology; SIF, Società Italiana di Farmacologia; SItI, Società Italiana di Igiene Medicina Preventiva e Sanità Pubblica.

Compliance with Ethical Standards

Funding

None.

Conflict of interest

Authors have no conflict of interest to disclose.

Ethical approval

This article does not contain data derived by any current studies with human participants performed by any of the authors. The clinical studies mentioned were provided with specific ethical approval.

References

  1. 1.
    Volpe M, Tocci G, Accettura D, Battistoni A, Bellone S, Bellotti P, Bertolotti M, et al. Consensus document and recommendations for the prevention of cardiovascular disease in Italy-2018. G Ital Cardiol. 2018;19(2 Suppl 1):1–95.Google Scholar
  2. 2.
    Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37:2315–81.CrossRefGoogle Scholar
  3. 3.
    Arena R, Guazzi M, Lianov L, et al. Healthy lifestyle interventions to combat noncommunicable disease—a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine. Mayo Clin Proc. 2015;90:1082–103.CrossRefGoogle Scholar
  4. 4.
    Sagner M, McNeil A, Puska P, et al. The P4 health spectrum—a predictive, preventive, personalized and participatory continuum for promoting healthspan. Prog Cardiovasc Dis. 2017;59:506–21.CrossRefGoogle Scholar
  5. 5.
    Rapporto Osservasalute 2016. Stato di salute e qualità dell’assistenza nelle regioni italiane. http://www.osservatorio-sullasalute.it/osservasalute/rapporto-osservasalute-2016. Accessed 5 Feb 2018.
  6. 6.
    Ministero della Salute. Rapporto annuale sull’attività di ricovero ospedaliero. Dati SDO 2015. Settembre 2016. http://www.salute.gov.it/imgs/C_17_pubblica-zioni_2548_allegato.pdf. Accessed 5 Feb 2018.
  7. 7.
    Palmieri L, Panico S, Vanuzzo D, et al. Gruppo di Ricerca del Progetto CUORE. La valutazione del rischio cardiovascolare globale assoluto: il punteggio individuale del Progetto CUORE. Ann Ist Super Sanita. 2004;40:393–9.PubMedGoogle Scholar
  8. 8.
    Il Progetto CUORE. Popolazione generale: stili di vita. http://www.cuore.iss.it/fattori/stili.asp. Accessed 5 Feb 2018.
  9. 9.
    Tocci G, Ferrucci A, Pontremoli R, et al. Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys. J Hum Hypertens. 2015;29:696–701.CrossRefGoogle Scholar
  10. 10.
    Tocci G, Muiesan ML, Parati G, Working Group of the Italian Society of Hypertension(SIIA) and SIIA Foundation, et al. Trends in prevalence, awareness, treatment, and control of blood pressure recorded from 2004 to 2014 during World Hypertension Day in Italy. J Clin Hypertens (Greenwich). 2016;18:551–556.Google Scholar
  11. 11.
    Volpe M, Erhardt LR, Williams B. Managing cardiovascular risk: the need for change. J Hum Hypertens. 2008;22:154–7.CrossRefGoogle Scholar
  12. 12.
    Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS Guidelines for the management of dyslipidemias: the Task Force for the Management of Dyslipidemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37:2999–3058.CrossRefGoogle Scholar
  13. 13.
    Willeit P, Kaptoge S, Welsh P, Natriuretic Peptides Studies Collaboration, et al. Natriuretic peptides and integrated risk assessment for cardiovascular disease: individual-participant-data meta-analysis. Lancet Diabetes Endocrinol. 2016;4:840–49.Google Scholar
  14. 14.
    Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans-fatty acids and cardiovascular disease. N Engl J Med. 2006;354:1601–13.CrossRefGoogle Scholar
  15. 15.
    Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014;349:g4490.CrossRefGoogle Scholar
  16. 16.
    Mancia G, Oparil S, Whelton PK, et al. The technical report on sodium intake and cardiovascular disease in low and middle income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association. Eur Heart J. 2017;38:712–9.PubMedGoogle Scholar
  17. 17.
    Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344:3–10.CrossRefGoogle Scholar
  18. 18.
    Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166:2437–45.CrossRefGoogle Scholar
  19. 19.
    Estruch R, Ros E, Salas-Salvado J, PREDIMED Study Investigators, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–90.CrossRefGoogle Scholar
  20. 20.
    Sanchez-Tainta A, Estruch R, Bullo M, PREDIMED Group, et al. Adherence to a Mediterranean-type diet and reduced prevalence of clustered cardiovascular risk factors in a cohort of 3204 high-risk patients. Eur J Cardiovasc Prev Rehabil. 2008;15:589–93.CrossRefGoogle Scholar
  21. 21.
    Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100:126–31.PubMedPubMedCentralGoogle Scholar
  22. 22.
    World Health Organization. Global recommendations on physical activity for health. Geneva: WHO; 2010.Google Scholar
  23. 23.
    American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975–91.Google Scholar
  24. 24.
    European Heart Failure Training Group. Experience from controlled trials of physical training in chronic heart failure: protocol and patients’ factors in effectiveness in the improvement in exercise tolerance. Eur Heart J. 1998;19:466–75.Google Scholar
  25. 25.
    Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006;368:666–78.CrossRefGoogle Scholar
  26. 26.
    Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27:155–61.CrossRefGoogle Scholar
  27. 27.
    Pi-Sunyer X, Astrup A, Fujioka K, For the SCALE Obesity and Prediabetes NN8022-1839 Study Group, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373:11–22.CrossRefGoogle Scholar
  28. 28.
    Greenway FL, Fujioka K, Plodkowski RA, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double blind, placebo-controlled, phase 3 trial. Lancet. 2010;376:595–605.CrossRefGoogle Scholar
  29. 29.
    Società Italiana di Chirurgia dell’Obesità e delle Malattie Metaboliche. Linee guida di chirurgia dell’obesità. Edizione 2016. SICOB. 2016:1–82. https://www.sicob.org/00_materiali/linee_guida_2016.pdf. Accessed 5 Feb 2018.
  30. 30.
    Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease. A report of the Surgeon General. Atlanta, GA: CDC; 2010. https://www.ncbi.nlm.nih.gov/books/NBK53017. Accessed 5 Feb 2018.
  31. 31.
    He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease—a meta-analysis of epidemiologic studies. N Engl J Med. 1999;340:920–6.CrossRefGoogle Scholar
  32. 32.
    Rice VH, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2001;(3):CD001188.Google Scholar
  33. 33.
    Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2012;(11):CD000146.Google Scholar
  34. 34.
    Cushman WC, Cutler JA, Hanna E, et al. Prevention and Treatment of Hypertension Study (PATHS): effects of an alcohol treatment program on blood pressure. Arch Intern Med. 1998;158:1197–207.CrossRefGoogle Scholar
  35. 35.
    Romero R, Bonet J, de la Sierra A, Aguilera MT, Esopoh Study Investigators. Undiagnosed obesity in hypertension: clinical and therapeutic implications. Blood Press. 2007;16:347–53.CrossRefGoogle Scholar
  36. 36.
    Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42:878–84.CrossRefGoogle Scholar
  37. 37.
    Fagard RH. Exercise therapy in hypertensive cardiovascular disease. Prog Cardiovasc Dis. 2011;53:404–11.CrossRefGoogle Scholar
  38. 38.
    Rosenberg L, Kaufman DW, Helmrich SP, Shapiro S. The risk of myocardial infarction after quitting smoking in men under 55 years of age. N Engl J Med. 1985;313:1511–4.CrossRefGoogle Scholar
  39. 39.
    Julius S, Nesbitt SD, Egan BM, Trial of Preventing Hypertension (TROPHY) Study Investigators, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med. 2006;354:1685–97.CrossRefGoogle Scholar
  40. 40.
    Luders S, Schrader J, Berger J, PHARAO Study Group, et al. The PHARAO study: prevention of hypertension with the angiotensin-converting enzyme inhibitor ramipril inpatients with high-normal blood pressure: a prospective, randomized, controlled prevention- trial of the German Hypertension League. J Hypertens. 2008;26:1487–96.CrossRefGoogle Scholar
  41. 41.
    Ference BA, Cannon CP, Landmesser U, Lüscher TF, Catapano AL, Ray KK. Reduction of low density lipoprotein-cholesterol and cardiovascular events with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors and statins: an analysis of FOURIER, SPIRE, and the Cholesterol Treatment Trialists Collaboration. Eur Heart J. 2018;39(27):2540–5.  https://doi.org/10.1093/eurheartj/ehx450.CrossRefPubMedGoogle Scholar
  42. 42.
    Chang Y, Robidoux J. Dyslipidemia management update. Curr Opin Pharmacol. 2017;33:47–55.CrossRefGoogle Scholar
  43. 43.
    Volpe M, Volpe R, Gallo G, Presta V, Tocci G, Folco E, Peracino A, Tremoli E, Trimarco B. 2017 Position Paper of the Italian Society for Cardiovascular Prevention (SIPREC) for an Updated Clinical Management of Hypercholesterolemia and Cardiovascular Risk: Executive Document Italian Society of Cardiovascular Prevention (SIPREC) Writing Committee. High Blood Press Cardiovasc Prev. 2017;24:313–29.CrossRefGoogle Scholar
  44. 44.
    Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–93.CrossRefGoogle Scholar
  45. 45.
    Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–91.CrossRefGoogle Scholar
  46. 46.
    Green JB, Bethel MA, Armstrong PW, Buse JB, Engel SS, Garg J, Josse R, Kaufman KD, Koglin J, Korn S, Lachin JM, McGuire DK, Pencina MJ, Standl E, Stein PP, Suryawanshi S, Van de Werf F, Peterson ED, Holman RR, TECOS Study Group. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2015;373:232–42.CrossRefGoogle Scholar
  47. 47.
    White WB, Cannon CP, Heller SR, Nissen SE, Bergenstal RM, Bakris GL, Perez AT, Fleck PR, Mehta CR, Kupfer S, Wilson C, Cushman WC, Zannad F, EXAMINE Investigators. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med. 2013;369:1327–35.CrossRefGoogle Scholar
  48. 48.
    Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, Ohman P, Frederich R, Wiviott SD, Hoffman EB, Cavender MA, Udell JA, Desai NR, Mosenzon O, McGuire DK, Ray KK, Leiter LA, Raz I, SAVOR-TIMI 53 Steering Committee and Investigators. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med. 2013;369:1317–26.CrossRefGoogle Scholar
  49. 49.
    Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, Skene AM, Tan MH, Lefèbvre PJ, Murray GD, Standl E, Wilcox RG, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine RJ, Korányi L, Laakso M, Mokán M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J, PROactive Investigators. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366:1279–89.CrossRefGoogle Scholar
  50. 50.
    Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE, EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117–28.CrossRefGoogle Scholar
  51. 51.
    Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, Shaw W, Law G, Desai M, Matthews DR, CANVAS Program Collaborative Group. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377:644–57.CrossRefGoogle Scholar
  52. 52.
    Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB, LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311–22.CrossRefGoogle Scholar
  53. 53.
    Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T, SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834–44.CrossRefGoogle Scholar
  54. 54.
    Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, Chan JC, Choi J, Gustavson SM, Iqbal N, Maggioni AP, Marso SP, Öhman P, Pagidipati NJ, Poulter N, Ramachandran A, Zinman B, Hernandez AF, EXSCEL Study Group. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017;377:1228–39.CrossRefGoogle Scholar
  55. 55.
    Ibanez B, James S, Agewall S, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology. Eur Heart. 2017;J2018(39):119–77.Google Scholar
  56. 56.
    Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:267–315.CrossRefGoogle Scholar
  57. 57.
    Bibbins-Domingo K. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2016;164(836–45):306.Google Scholar
  58. 58.
    Thun MJ, Jacobs EJ, Patrono C. The role of aspirin in cancer prevention. Nat Rev Clin Oncol. 2012;9:259–67.CrossRefGoogle Scholar
  59. 59.
    Volpe M, Abrignani MG, Borghi C, et al. La terapia con aspirina nella prevenzione cardiovascolare primaria. Documento di consenso intersocietario italiano. G Ital Cardiol. 2014;15:442–51.Google Scholar
  60. 60.
    Volpe M, Degli Esposti L, Romeo F, et al. Il ruolo dell’aderenza al trattamento farmacologico nella terapia cronica delle malattie cardiovascolari: documento intersocietario di consenso. G Ital Cardiol. 2014;15(10 Suppl 1):3S–10S.Google Scholar
  61. 61.
    Ministero della Salute. Prevenzione e controllo dell’influenza, raccomandazioni per la stagione 2017–2018. http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=italiano&-menu=notizie&p=dalministero&id=3037. Accessed 5 Feb 2018.
  62. 62.
    LeBras MH, Barry AR. Influenza vaccination for secondary prevention of cardiovascular events: a systematic review. Can J Hosp Pharm. 2017;70:27–34.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Kyaw MH, Rose CE Jr, Fry AM, et al. The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. J Infect Dis. 2005;192:377–86.CrossRefGoogle Scholar
  64. 64.
    Ren S, Newby D, Li SC, et al. Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: a systematic review and meta-analysis. Open Heart. 2015;2:e000247.CrossRefGoogle Scholar
  65. 65.
    Corrales-Medina VF, Suh KN, Rose G, et al. Cardiac complications in patients with community-acquired pneumonia: a systematic review and meta-analysis of observational studies. PLoS Med. 2011;8:e1001048.CrossRefGoogle Scholar
  66. 66.
    Alicino C, Trucchi C, Paganino C, et al. Incidence of herpes zoster and post-herpetic neuralgia in Italy: results from a 3-years population-based study. Hum Vaccin Immunother. 2017;13:399–404.CrossRefGoogle Scholar
  67. 67.
    Lin HC, Chien CW, Ho JD. Herpes zoster ophthalmicus and the risk of stroke: a population-based follow-up study. Neurology. 2010;74:792–7.CrossRefGoogle Scholar
  68. 68.
    Sreenivasan N, Basit S, Wohlfarth J, et al. The short- and long-term risk of stroke after herpes zoster—a nationwide population-based cohort study. PLoS One. 2013;8:e69156.CrossRefGoogle Scholar
  69. 69.
    Breuer J, Pacou M, Gauthier A, Brown MM. Herpes zoster as a risk factor for stroke and TIA: a retrospective cohort study in the UK. Neurology. 2014;82:206–12.CrossRefGoogle Scholar
  70. 70.
    Langan SM, Minassian C, Smeeth L, Thomas SL. Risk of stroke following herpes zoster: a self-controlled case-series study. Clin Infect Dis. 2014;58:1497–503.CrossRefGoogle Scholar
  71. 71.
    Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338:1650–6.CrossRefGoogle Scholar
  72. 72.
    August CP, Caprio S, Fennoy I, Endocrine Society, et al. Prevention and treatment of pediatric obesity: an Endocrine Society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008;93:4576–99.CrossRefGoogle Scholar
  73. 73.
    Spinelli A, Lamberti A, Nardone P, et al. Sistema di sorveglianza OKkio alla SALUTE: risultati 2010. Roma: Istituto Superiore di Sanità; 2012 (Rapporti ISTISAN 12/14).Google Scholar
  74. 74.
    Expert Panel on Integrated Guidelines for Cardiovascular Health, and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128(Suppl 5):S213–56.Google Scholar
  75. 75.
    Agostoni C, Braegger C, Decsi T, ESPGHAN Committee on Nutrition, et al. Role of dietary factors and food habits in the development of childhood obesity: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2011;52:662–9.CrossRefGoogle Scholar
  76. 76.
    Kelley GA, Kelley KS, Pate RR. Effects of exercise on BMI z-score in overweight and obese children and adolescents: a systematic review with meta-analysis. BMC Pediatr. 2014;14:225.CrossRefGoogle Scholar
  77. 77.
    Ferri C, et al. Management of Hypertension in the elderly and frail elderly. High Blood Press Cardiovasc Prev.  https://doi.org/10.1007/s40292-017-0185-4.CrossRefGoogle Scholar
  78. 78.
    Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e136–9.Google Scholar
  79. 79.
    Williamson JD, Supiano MA, Applegate WB, SPRINT Research Group, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥ 75 years: a randomized clinical trial. JAMA. 2016;315:2673–82.CrossRefGoogle Scholar
  80. 80.
    Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA. 2014;312:1136–44.CrossRefGoogle Scholar
  81. 81.
    Bertolotti M, Franchi C, Rocchi MB, REPOSI Investigators, et al. Prevalence and determinants of the use of lipid-lowering agents in a population of older hospitalized patients: the findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study. Drugs Aging. 2017;34:311–9.CrossRefGoogle Scholar
  82. 82.
    Cannon CP, Blazing MA, Giugliano RP, IMPROVE-IT Investigators, et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387–97.CrossRefGoogle Scholar
  83. 83.
    Heida KY, Franx A, van Rijn BB, et al. Earlier age of onset of chronic hypertension and type 2 diabetes mellitus after a hypertensive disorder of pregnancy or gestational diabetes mellitus. Hypertension. 2015;66:1116–22.PubMedGoogle Scholar
  84. 84.
    Kharazmi E, Dossus L, Rohrmann S, Kaaks R. Pregnancy loss and risk of cardiovascular disease: a prospective population-based cohort study (EPIC-Heidelberg). Heart. 2011;97:49–54.CrossRefGoogle Scholar
  85. 85.
    Società Italiana per la Prevenzione Cardiovascolare(SIPREC). La prevenzione dell’infarto del miocardio nella donna, 2009. http://www.sciencepromotion.it/wp-content/uploads/2016/08/Doc_Prevenzione-infarto-miocardio-donna.pdf. Accessed 5 Feb 2018.
  86. 86.
    Meeks KA, Freitas-Da-Silva D, Adeyemo A, et al. Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis. Intern Emerg Med. 2016;11:327–40.CrossRefGoogle Scholar
  87. 87.
    Modesti PA, Castellani S, Calabrese M, Malandrino D, Zhao D. Comparison of type 2 diabetes prevalence in Chinese migrants vs Caucasians and new perspectives for screening of cerebrovascular disease in Chinese: a proof of concept study. Diabetes Res Clin Pract. 2017;130:196–203.CrossRefGoogle Scholar
  88. 88.
    Modesti PA, Han Y, Jing Y, et al. Disegno e modalità di realizzazione dello studio CHIP (CHinese In Prato). Epidemiol Prev. 2014;38:357–63.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and PsychologySant’Andrea Hospital, University of Rome SapienzaRomeItaly
  2. 2.IRCCS NeuromedPozzilliItaly

Personalised recommendations