From classical to innovative clinical epidemiology: the 50 years' experience of the Brisighella Heart Study.

INTRODUCTION The Brisighella Heart Study (BHS) is a long-term, prospective, population-based longitudinal study on 2939 randomly selected residents of the town of Brisighella, Emilia-Romagna, Italy. EVIDENCE ACQUISITION At the enrollment time in 1972 no participant had any cardiovascular disease, 1491 participants were men and 1448 women, and the age span was 14 to 84 years. EVIDENCE SYNTHESIS The observational phase of the study contributed to the evidence of a strong pathophysiological association between hypercholesterolemia and hypertension. The interventional phase was one of the first examples of successful cardiovascular risk reduction obtained through a population-based educational intervention. Currently, the BHS staff is planning its 11th four-yearly population survey in 2022. Today, the study is moving from an epidemiological perspective to a translational approach, involving advanced biomolecular analyses, genetic tests, and functional vascular investigations. CONCLUSIONS This review aims to summarize the main findings of the first 50 years of BHS research and spot the latest developments and future perspectives of this remarkable Italian cardiovascular study.