動脈動脈瘤の世界的な疫学研究:公衆衛生対策により,腹動脈動脈瘤による死亡率をさらに減らすことができます
David Sidloff1, Philip Stather, Nikesh Dattani
1Vascular Surgery Group, Department of Cardiovascular Sciences (D.S., P.S., N.D., M.B., R.S., E.C.) and Department of Health Sciences (J.T.), University of Leicester, Leicester, UK.
Circulation
|November 20, 2013
まとめ
全世界の腹動脈動脈瘤 (AAA) 死亡率は普遍的に減少していないが,国によって有意な差異がある. 喫煙率の低下はAAA死亡率の減少と最も強い相関関係を示しているが,肥満はパラドックスである.
科学分野:
- 心血管疾患の疫学について
- 公衆衛生は公衆衛生である.
背景:
- 西洋のデータは,腹動脈動脈瘤 (AAA) による死亡率の減少を示唆しているが,世界の傾向は不明である.
- 国際的なAAA死亡率と,心血管疾患の危険因子との関連を調査することは極めて重要です.
研究 の 目的:
- 1994年から2010年までの腹動脈動脈瘤 (AAA) 死亡率における世界的な傾向を調べる.
- AAA死亡率と心血管疾患のリスク因子の関連性を分析する.
主な方法:
- 世界保健機関 (WHO) の死亡率データと,WHO加盟国19カ国のリスク因子統計を活用した.
- 心血管疾患リスク因子の時間的な傾向とAAA死亡率を相関させるための回帰分析を行った.
主要な成果:
- AAA死亡率の傾向は,世界的に有意な異質性を示しており,米国と英国が最も減少している.
- AAAの死亡率は欧州のいくつかの国で増加しており,普遍的ではない減少を示しています.
- AAA死亡率と静脈動脈血圧,コレステロール,喫煙率との間の肯定的な関連性が見つかりました. ボディ・マス・インデックスとの逆関連が認められた.
結論:
- 世界的なAAA死亡率は均等に減少していないが,国内的な変動は心血管疾患のリスク因子に関連している.
- 喫煙者の減少は,AAAによる死亡率の減少と強く相関しています.
- AAA死亡率における"肥満パラドックス"は,公衆衛生戦略のさらなる調査を必要とする.
関連する概念動画
Aneurysm III: Interprofessional Care
478
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
478
Aneurysm II: Clinical Manifestations and Diagnostic Studies
592
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
592
Aneurysm I: Introduction
658
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
658
Aneurysm IV: Nursing Management
625
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
625
Aortic Regurgitation III: Medical Management
598
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
Atherosclerosis III: Management
747
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
747


