フレミングハム心臓研究 (Framingham Heart Study) の最新版の一般心血管リスクプロフィールの体系的な検討
Amanda K Marma1, Donald M Lloyd-Jones
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, Suite 1102, Chicago, IL 60611, USA.
Circulation
|July 22, 2009
まとめ
更新されたFraminghamリスクツールは,年齢が重要なことを示していますが,喫煙や糖尿病などの高リスク要因は,若い個人に影響を与えることができます. 血管年齢に関するコミュニケーションは,リスクを理解するのに役立ちます.
科学分野:
- 心臓病学 心臓病学
- 予防医学は,予防的な医療です.
- リスク評価 リスク評価
背景:
- 新しいFraminghamリスク予測ツールには,一般的な心血管疾患のエンドポイントが含まれています.
- それは,リスクコミュニケーションのための"血管年齢"の概念を導入します.
研究 の 目的:
- リスク要因の組み合わせと,心血管疾患リスクの値に対するその影響を分析する.
- リスクファクターの重荷が"血管年齢"にどのように変化するかを理解する.
主な方法:
- 更新されたリスク予測ツールの体系的な検討.
- 予測されたリスクアウトプットを観察するために,個々のおよび組み合わせたリスクファクターレベルを変化させる.
- 高リスクを10年後の予測リスク>=20%として定義する.
主要な成果:
- 年齢は,男女ともに,10年間の心血管疾患のリスクの主な決定因子です.
- 複数の危険因子を持つ若い個人は,依然として予測されるリスクが低い可能性があります.
- 高リスク (>=20%) は,リスク要因 (喫煙,糖尿病) が有意な35歳以上の男性および40歳以上の女性において発生する可能性があります.
- 10年後の予測リスクは,45歳の男性では3.1%から46.8%,55歳の女性では2.4%から42.7%であった.
- 血管の年齢は幅広く変化しており,45歳の男性では37歳から80歳以上,55歳の女性では39歳から80歳以上であった.
結論:
- ツールの拡張エンドポイントは,年齢を問わず予測されたリスク範囲を増加させます.
- リスク要因が大きい若い人は,10年後のリスクが低い可能性があります.
- "血管年齢"メトリックは,時系列的な年齢を超えて,心臓血管リスクに関する広範なコミュニケーションツールを提供します.
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