Cardiovascular risk factors in Italy

In the 1950s the Italian population was known for its low mean levels of ma jor cardiovascular risk factors and serum cholesterol in particular. A defi nite increase of those mean levels was associated, in the next 2 decades, w ith increasing death rates from cardiovascular diseases and coronary heart disease. Between the late 1970s and early 1990s cardiovascular death rates declined by over 40%. Large population surveys showed, between 1978 and 198 7, small decreases in the mean levels of blood pressure (in both sexes), of smoking habits (in men), and of body weight (in women), while serum choles terol remained stable. These changes mathematically explained about two-thi rds of the observed decline in cardiovascular mortality among middle-aged p eople. In the late 1980s and early 1990s scattered population studies sugge sted a decline in mean population levels of serum cholesterol, at least in some areas of the country. More coordinated or systematic preventive campai gns were organized by the public health authorities. On the other hand acti vities of many small private organizations dealing with heart health likely explain the spread of knowledge, attitude, and practice in the prevention of cardiovascular diseases. Food industry started to produce low-fat produc ts and to label foods with nutrition facts. Changes in food consumption in the beneficial direction started to be recorded in the late 1980s. The spre ad of antihypertensive treatment was partly favored by the National Health Service offering anti-hypertensive drugs at relatively low cost. Government regulations have more and more restricted the public areas where smoking i s allowed. An increasing interest for prevention on the part of physicians is a recent issue, mainly bound to the success of some major controlled tri als of hypocholesterolemic drugs. (C) 1999 American Health Foundation and A cademic Press.