by Maria Giovanna Faiella
the estimate of the Italian Society of Geriatric Cardiology based on the results of a study. Cardiovascular diseases are the first cause of death in Italy, but there are no structured screening programs such as the oncological ones included in the Lea
Cardiovascular diseases are the leading cause of death in Western countries, including ours. Early diagnosis remains a fundamental tool for protecting heart health and counteracting the onset and progression of these pathologies, as it allows patients to be promptly guaranteed the necessary treatment, thus avoiding disabling outcomes, within a few years , or even death. According to the estimates of Italian Society of Geriatric Cardiology (SICGe), on the basis of the PREVASC study (PREvalence of cardioVASCular diseases), 150,000 deaths a year could be avoided if structured screening programs such as oncology were adopted for the early diagnosis of three types of cancer – uterine cervix, breast and colon- rectum – , guaranteed free of charge within the Essential levels of assistance (Lea), i.e. the services that the National Health Service must ensure to all citizens, regardless of their place of residence. Hence the appeal to the institutions by doctors and experts, during a meeting in the Chamber of Deputies, to guarantee at least the elderly population over 65 life-saving cardiological screenings, such as for cancer.
I study
The PREVASC study, conducted by SICGe and aimed at identifying the prevalence and severity of heart disease widespread among the elderly, such as atrial fibrillation, heart failure, valve disease, involved approximately 1,200 people over 65 in ten heart villages – small towns with less of three thousand inhabitants of various Italian regions – who underwent a cardiological examination and an electrocardiogram (ECG) followed, in the event of anomalies, by an echocardiogram.
Well, the study highlights the presence of cardiovascular risk factors that were ignored by the subjects who participated in the screening, so they were not treated. In particular, out of 1,200 people examined, more than 8 out of 10 suffer from hypertension (but did not know it), 19 percent from diabetes, 56 percent from dyslipidemia, therefore have alterations in the amount of fat in the blood (triglycerides and cholesterol ). In addition, nearly one in three older adults had aortic valve abnormalities and, in 34 percent of cases, mitral valve abnormalities.
Prevention saves quality and duration of life
Comments Niccol Marchionni, president of the Italian Society of Geriatric Cardiology: All these new diagnoses with silent symptoms and risk factors, for which the elderly examined were not under treatment, would have generated clinically relevant cardiac pathologies in the following years.
The study demonstrates once again that targeted screening activities bring out latent pathologies. Prevention is essential to safeguard the quality and length of life of the elderly population underlines Marchionni. Adds Alessandro Boccanelli, vice president of SICGe and coordinator of the PREVASC study: Cardiological screening easily adoptable. For a timely diagnosis of cardiovascular pathologies, the heart can be auscultated with a phonendoscope and, if a suspect is identified, subsequent simpler tests such as an electrocardiogram or more in-depth tests, such as an echocardiogram, can be carried out. Unfortunately – underlines Boccanelli – this practice is not included among the checks carried out in the normal medical routine. Yet, as well as being the leading cause of death and among the main causes of disability, as Fulvio Colivicchi, past-president of the National Association of Hospital Cardiologists (ANMCO) and vice-president of the Italian Federation of Medical Societies (FISM) recalls, cardiovascular diseases are also the first cause of hospitalization and access to outpatient clinics.
The commitment of the institutions
The data from the study push the legislator to consider cardiological screening of the elderly as an opportunity to save lives and make active aging an effective reality, said the president of the Social Affairs Commission of the Chamber, the ‘the honorable Ugo Cappellacci , who is committed to embarking on a process with cardiology scientific societies in order to make heart disease prevention processes structural in a context of sustainability for the National Health Service, since resources are not infinite.
But will cardiological screening for the over 65 population be included, like cancer screening, in the essential levels of assistance? Mr Cappellacci replies: If the result is to protect people’s lives, improve their quality of life and also achieve savings, ultimately, for the Health Service, there is no reason not to go in this direction. He was echoed by the deputy Annarita Patriarca, member of the Social Affairs Commission: With my colleagues in the Chamber I will commit myself to providing concrete and structured answers on the needs highlighted in terms of prevention of heart disease in the elderly; in this perspective, community screenings are a strategy to be studied in depth to avoid deaths and try to ensure peaceful aging for the over 65s.
July 5, 2023 (change July 5, 2023 | 09:36)
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