1999年から2020年までの米国における高齢者におけるアミロイドーシスおよび心血管疾患による死亡率の顕著な格差
Mustafa Shehzad1, Dawood Shehzad2, Logan Johnke2
1Internal Medicine Residency Program, Hackensack University Medical Center.
まとめ
アミロイドーシス (タンパク質の折り畳み障害) に起因する心血管疾患による死亡率は,1999年から2020年にかけて,65歳以上の米国人の間で著しく増加した. 性別,人種,地域によって不平等が存在し, 標的を絞った公衆衛生の介入が必要である.
科学分野:
- 心血管医学
- ゲロントロジー
- 公衆衛生
背景:
- アミロイド症は タンパク質の誤った折り畳みと アミロイド線維の蓄積を伴うもので 臓器の機能障害を引き起こします
- 心血管の合併症はアミロイドーシス患者にとって大きな懸念事項です.
- 死亡率の傾向を理解することは公衆衛生戦略にとって極めて重要です
研究 の 目的:
- 1999年から2020年までの米国高齢者 (≥65歳) のアミロイドーシスに関連した心血管疾患による死亡率の傾向を調査する.
- これらの死亡傾向における 人口,人種,地理的格差を特定する.
- 標的を絞った介入を促し 患者の治療結果を改善する
主な方法:
- 1999年から2020年までの米国の死亡率データをCDC WONDERデータベースを利用した.
- アミロイドーシスに関連する心血管疾患による死亡率 (AAMR) を分析した.
- 年齢,性別,人種,地理的地域による階層化されたデータ
主要な成果:
- AAMRは1999年の1.71から2020年には4.23に増加し,2018年以降は加速した.
- 男性と非ヒスパニック系黒人は,それぞれ女性や他の人種と比較して高いAAMRを示した.
- 東北と西部の地域では死亡率が最も高く,南部の地域では黒人が多いにもかかわらず死亡率が低い.
結論:
- アミロイドーシスに関連した心臓血管疾患による死亡率の大幅な増加と格差は,公衆衛生上の注意の必要性を強調しています.
- 観察された傾向は,単に罹患率の増加ではなく,診断と報告の改善を反映している可能性があります.
- アミロイドーシスの増大する負担に対処するために,標的を絞った介入,改善された診断,治療戦略が緊急に必要です.
関連する概念動画
01:26Alzheimer's Disease: Overview
666
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
666
01:17Ischemic Heart Disease: Overview
1.4K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.4K
01:26Coronary Artery Disease II: Pathophysiology
33
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
33
03:03Amyloid Fibrils
9.8K
Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
9.8K
01:26Atherosclerosis III: Management
33
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...
33
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
38
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
38