心血管リスク因子の変化と心血管事件の関連
Thomas T van Sloten1,2,3, Muriel Tafflet1,2, Marie-Cécile Périer1,2
1Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
JAMA
|November 7, 2018
まとめ
心血管の健康指標の改善は,心血管疾患 (CVD) のリスクを一貫して低下させなかった. 適度または高い心血管健康を維持することは有益であったが,健康カテゴリーの変化だけでは,CVDの発生率の信頼できる予測指標ではなかった.
科学分野:
- 心血管の健康
- 流行病学について
- 公衆衛生
背景:
- 理想的な心血管の健康は,心血管疾患 (CVD) のリスクの減少と関連しています.
- 以前の研究では 心血管の健康を測るのに 単一の測定値しか使っていなかったのです
- 時間の経過とともに心血管の健康状態の変化が 心血管疾患の発生率にどのように影響するかを理解することは極めて重要です
研究 の 目的:
- 心血管の健康状態の変化と心血管疾患の発生リスクとの関連を調査する.
- 心血管健康の異なる経路が心血管疾患のアウトカムに与える影響を分析する.
主な方法:
- イギリスにおける前向きなコホート研究 (ホワイトホールII)
- 心血管の健康は,アメリカ心臓協会の7つの指標 (喫煙,BMI,運動量,食事,血圧,断食中のグルコース,総コレステロール) を用いて評価され,低,中等,または高に分類されます.
- 10年間の心血管健康の変化 (1985年/1988年~1997年/1999年) の分析と2017年まで発生した心血管疾患の追跡調査
主要な成果:
- 前回のCVDのない6326人の参加者の中で,中央値の18. 9年の追跡期間で114件のCVDイベントが発生しました.
- 心血管の健康状態が持続的に低下することは,より高い心血管疾患の発生率 (1000人年当たり9. 6) と関連していた.
- 一貫して中等,中等から高い,高から低い,高から中等,および一貫して高い心血管疾患の健康カテゴリーは,持続的に低い健康と比較して有意に低いCVDリスクを示しました.
結論:
- 心血管疾患のカテゴリーの変化の方向とCVDリスクとの間には一貫した関係が見つかりませんでした.
- 特定の変化の軌跡よりも 適度または高いレベルの心血管の健康を維持することが 重要視される.
- これらの発見は,長期的なCVD予防のための持続的な理想的な心血管健康指標の重要性を強調しています.
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