Prevalence of ‘Borderline’ Values of Cardiovascular Risk Factors in the Clinical Practice of General Medicine in Italy

Results of the BORDERLINE Study
  • Giuliano Tocci
  • Andrea Ferrucci
  • Jasmine Passerini
  • Maurizio Averna
  • Paolo Bellotti
  • Graziella Bruno
  • Francesco Cosentino
  • Gaetano Crepaldi
  • Cristina Giannattasio
  • Maria Grazia Modena
  • Giulio Nati
  • Antonio Tiengo
  • Bruno Trimarco
  • Diego Vanuzzo
  • Massimo Volpe
Original Research Article


Introduction: 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.

Aim: 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.


borderline risk high-normal risk cardiovascular prevention global cardiovascular risk blood pressure cholesterol glucose 

Supplementary material

40292_2012_18020043_MOESM1_ESM.pdf (205 kb)
Supplementary material, approximately 210 KB.


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Copyright information

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Authors and Affiliations

  • Giuliano Tocci
    • 1
  • Andrea Ferrucci
    • 1
  • Jasmine Passerini
    • 1
  • Maurizio Averna
    • 2
  • Paolo Bellotti
    • 3
  • Graziella Bruno
    • 4
  • Francesco Cosentino
    • 1
  • Gaetano Crepaldi
    • 5
  • Cristina Giannattasio
    • 6
  • Maria Grazia Modena
    • 7
  • Giulio Nati
    • 8
  • Antonio Tiengo
    • 9
  • Bruno Trimarco
    • 10
  • Diego Vanuzzo
    • 11
  • Massimo Volpe
    • 1
    • 12
  1. 1.Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of MedicineUniversity of Rome “Sapienza”, Sant’Andrea HospitalRomeItaly
  2. 2.Department of Internal Medicine and Medical SpecialtiesUniversity of PalermoPalermoItaly
  3. 3.Division of CardiologySan Paolo HospitalSavonaItaly
  4. 4.Department of Internal MedicineUniversity of TurinTurinItaly
  5. 5.CNR, Institute of Neuroscience, Section on AgingPadovaItaly
  6. 6.Division of Clinical MedicineMilano Bicocca University and San Gerardo HospitalMonzaItaly
  7. 7.Division of Cardiology, Department of Emergency and UrgencyUniversity of ModenaModenaItaly
  8. 8.Italian Society of General Medicine (SIMG)RomeItaly
  9. 9.Chair of Metabolic Disorders, Department of Clinical and Experimental MedicineUniversity of PadovaPadovaItaly
  10. 10.Department of Clinical Medicine, Cardiovascular and Immunological SciencesFederico II University HospitalNaplesItaly
  11. 11.Cardiovascular Prevention Centre, Health Unit 4 “Medio Friuli”UdineItaly
  12. 12.IRCCS NeuromedPozzilli, IserniaItaly

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