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[Incidence and prediction of coronary heart disease in the Italian cohorts of the Seven Countries Study. 10 year experience (author's transl)].

Three cohorts of man aged 40-59 at entry have been enrolled in Italy within the Seven Countries Study and followed-up for 10 years. They included demographic samples in the rural areas of Crevalcore, north Italy (n. 993) and of Montegiorgio, central Italy (n. 719) and a sample of Railroad men living in Rome and surroundings (n. 768) with an entry participating of about 92% and a 5 and 10 year follow-up participating of about the same level. Incidence of coronary heart disease in 10 years in men coronary-free at entry has been, for the pool of the three cohorts, of about 0.4% per year for hard criteria coronary heart disease (coronary deaths and hard infarcts) and of about 1% per year for all kinds of coronary heart disease including softer diagnoses. Differences between cohorts were small and altogether not significant except for coronary deaths which were higher in the Railroad group than in Montegiorgio. The prediction of coronary heart disease as function of the entry levels of some risk factors, estimated by the multiple logistic equation, suggested that also for these Italian samples, age, blood pressure, serum cholesterol, smoking habits and physical activity (the latter with a protective role) are the main risk factors although cholesterol seems to play a lesser role in the Railroad group than in the Rural cohorts. Proportions of 34 to 68% of the observed cases were located in the upper 20% of the distribution of the estimated risk and the ratio between cases in the upper and bottom quintile of risk ranged 4 to 14 folds. The degree of discrimination suggested by these and other indicators resulted to be directly related to the severity of the coronary heart disease manifestations considered as end-points (deaths, hard cases, all cases). Such varying discriminating role was mainly due to the varying predicting power of serum cholesterol.