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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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  1. ホーム
  3. 冠動脈カルシウムは,抗高血圧治療の開始と強化に個別化されたリスクベースのアプローチを導く
  1. ホーム
  3. 冠動脈カルシウムは,抗高血圧治療の開始と強化に個別化されたリスクベースのアプローチを導く

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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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冠動脈カルシウムは,抗高血圧治療の開始と強化に個別化されたリスクベースのアプローチを導く

John W McEvoy1, Seth S Martin2, Zeina A Dardari2

  • 1From Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., S.S.M., Z.A.D., W.S.P., K.N., R.S.B., M.J.Blaha); Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S.); Heart and Vascular Center of Excellence, Wake Forest Baptist Health, Winston-Salem, NC (J.Y.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J.Budoff); Department of Epidemiology, Colorado School of Public Health, Aurora (D.C.G.); Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle (B.M.P.); and Center for Healthcare Advancement and Outcomes and Miami Cardiac and Vascular Institute, Baptist Health South Florida (K.N.). jmcevoy1@jhmi.edu.

Circulation
|November 25, 2016

PubMed で要約を見る

まとめ
この要約は機械生成です。

冠動脈カルシウム (CAC) 画像は,静脈動脈血圧 (SBP) 治療の強度を個人化するのに役立ちます. 動脈硬化性心血管疾患 (ASCVD) のリスクと組み合わせたCACは,特に高血圧前または軽度の高血圧の患者にとって,SBPの目標を導く.

キーワード:
抗高血圧療法心血管疾患のリスク冠動脈カルシウムシストリック血圧

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科学分野:

  • 心臓病科
  • 予防 医療
  • 医療用イメージング

背景:

  • 動脈硬化性心血管疾患 (ASCVD) のリスクを用いた静脈血圧 (SBP) 治療目標の個別化がますます重要になっています.
  • 冠動脈カルシウム (CAC) 画像は,抗高血圧治療の強度に関するさらなる指針を提供することができます.

研究 の 目的:

  • CACイメージングがSBPの治療強度の割り当てを洗練できるかどうかを調査する.
  • 伝統的なASCVDリスクスコアを超えて,心血管リスクの階層化におけるCACの役割を評価する.

主な方法:

  • 動脈硬化多民族研究 (MESA) に参加した3733人のSBP120〜179mmHgの分析
  • SBPによる階層化,10年間のASCVDリスク,およびCACスコア (0,1-100, >100).
  • ASCVDまたは心不全の多変量調整された危険比の比較と,集中的なSBP目標の治療に必要な数の推定.

主要な成果:

  • SBP < 160 mm Hg の個体では,特にASCVDリスクが < 15% の場合,CACは著しく分層化されました.
  • 例えば,ASCVDリスク <15%とSBP 120~159 mm Hgの患者では,高いCACスコアは,イベントの危険性比の増加と相関していた.
  • ASCVDのリスクに関係なく,SBPが160 - 179mmHgであったとき,CACとイベントの間の明確な関連は観察されなかった.

結論:

  • 組み合わせたCAC画像とASCVDリスク評価は,個別化されたSBP治療目標 (例えば,140対120mmHg) を導くことができます.
  • このアプローチは,推定ASCVDリスクの5% - 15%と高血圧前または軽度の高血圧を有する成人に特に有益です.
  • CACイメージングは,より高いASCVDリスクの値を満たさない個体に対するリスクの階層化に付加価値をもたらします.