Bicocca Epidemiological Assessment of Cardiovascular Risk Factors

to define the prevalence of the exposome associated with increased CV risk in an urban population.

The exposome includes the following domains:

• Internal: internal biological processes such as oxidative stress, inflammation, epigenetic changes, metabolism and the internal microbiome.
• General external: social, economic factors, the urban environment and climate factors.
• Specific external: an individual's immediate local environment, including exposure to chemicals, diet, physical activity, tobacco and infections.

the prevalence of the known CV risk factors (e.g., high blood pressure, diabetes, smoking status, dyslipidaemia) will be evaluated according to current Guidelines for Cardiovascular Prevention.

In addition to this the following known risk factors will be determined as follows

• The non-adequacy of physical activity will be established based on the IPAQ total score. A score below 3000 MET-minute/week is indicative of an inactive lifestyle. Also, the categorical score that identifies "inactive," "minimally active," and "HEPA active" will be used to classify participants;
• The non-adequacy of eating habits will be established based on the MD score of the QueMD scale. A score below 5 suggests good adherence to the Mediterranean diet;
• Alcohol consumption will be evaluated through the individual scores on the AUDIT-C. A score equal to or greater than 5 for males and equal to or greater than 4 for females indicates a possible risky consumption of alcohol.

prevalence of new/less studied risk modifiers (including psychological profiles associated with unhealthy lifestyle and misperception of CV risk) in an urban population.

Specifically:

• the prevalence of psychosocial stress will be determined through the evaluation of individual scores on the PSS.
• the presence of anxiety symptoms will be determined by evaluating individual scores on the GAD-7;
• the presence of depressive symptoms will be evaluated through the individual scores on the PHQ-9;
• the prevalence of frailty in the elderly participants will be determined according to the Fried's frailty phenotype;
• the prevalence of short (<6 hours of sleep) and long sleepers (>8 hours of sleep) will be defined by the Pittsburgh sleep quality index;
• the prevalence of low socioeconomic status will be determined as well as work stress defined by job strain (i.e. the combination of high demands and low control at work) and effort-reward imbalance.

The prevalence of clinical conditions associated with CV risk will be determined as follows:

• The prevalence of sleep disturbances will be defined according to the presence of sleep disorders as defined by the International Classification of Sleep Disorders (third edition);
• The prevalence of cancer will be determined based on past medical history;
• The prevalence of chronic obstructive pulmonary disease will be determined based on past medical history and will be supported by the results of spirometry;
• The prevalence of migraine will be determined based on past medical history;
• The prevalence of erectile dysfunction, defined as the consistent inability to reach and maintain an erection satisfactory for sexual activity will be determined based on past medical history
• The prevalence of polycystic ovary syndrome and premature menopause will be determined based on past medical history
• The prevalence of inflammatory conditions such as rheumatoid arthritis, psoriasis and ankylos