Favorable cardiovascular risk profile and 10-year coronary heart disease incidence in women and men: Results from the Progetto CUORE

Luigi Palmieri*, Chiara Donfrancesco, Simona Giampaoli, Michela Trojani, Salvatore Panico, Diego Vanuzzo, Lorenza Pilottoc, Giancarlo Cesana, Marco Ferrario, Paolo Chiodini, Roberto Sega, Jeremiah Stamler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Cardiovascular risk factor research has recently broadened its focus based on new data indicating the benefits of low risk, i.e. favorable levels of all major risk factors. The aims of this study were to assess further the relation of low risk to coronary heart disease risk, and implications for prevention. We conducted a prospective population-based Italian study, of 7438 men and 13 009 women aged 35–69 years, with a mean follow-up of 10.4 years and validated first coronary events. Baseline coronary heart disease risk was classified into three categories: low risk; unfavorable but not high risk; and high risk. To analyze the relation of these risk profiles to coronary heart disease incidence, age-adjusted, sex-averaged coronary heart disease incidence was calculated for persons free of coronary heart disease and stroke, stratified as baseline low risk, unfavorable but not high risk or high risk. To assess the independent relationship of individual risk factors to coronary heart disease incidence, multivariate proportional hazards models were computed for combinations of risk factors. Only 2.7% of participants met low risk criteria; 81.4% were high risk. Age-adjusted coronary heart disease incidence for the whole cohort was 37.1 out of 10000 person-years (men 59.0; women 15.3). No coronary heart disease events occurred in low-risk men, only two in low-risk women. For women and men who were not high risk, the age-sex standardized coronary heart disease rate was 62% lower than for high-risk participants. Blood pressure, need for antihypertensive medication, smoking, hyperglycemia, diabetes, total and high-density lipoprotein cholesterol were independently related to coronary heart disease risk. Favorable levels of all modifiable readily measured risk factors - rare among Italian adults - assure minimal coronary heart disease risk. Population-wide prevention is needed, especially improved lifestyles, to increase the proportion of the population at low risk.

Original languageEnglish (US)
Pages (from-to)562-570
Number of pages9
JournalEuropean journal of preventive cardiology
Issue number4
StatePublished - Aug 2006


  • acetylcholine
  • arteries
  • endothelial function
  • exercise
  • nitric oxide

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

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