冠状动脉心脏病患者中常规风险因素的患病率
Umesh N Khot1, Monica B Khot, Christopher T Bajzer
1Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA. khot@cvresearch.net
JAMA
|August 21, 2003
概括
大多数冠心病 (CHD) 患者都有传统的危险因素,如吸烟,糖尿病,高血压和高胆固醇. 公共卫生工作应优先考虑这些因素,以对抗慢性心血管疾病.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 传统观点认为,超过50%的冠心病 (CHD) 患者缺乏传统的危险因素 (吸烟,糖尿病,高脂血症,高血压).
- 这种看法激发了对非传统风险因素和对冠状动脉疾病的遗传倾向的兴趣.
- 这项研究通过检查大量心血管疾病患者队列中常规风险因素的流行率来挑战这一概念.
研究的目的:
- 在被诊断为冠心病 (CHD) 的患者中确定四种常规风险因素的实际患病率.
主要方法:
- 分析了10年 (2002-2003) 进行的14项国际慢性心脏病随机临床试验中的122,458名患者的数据.
- 包括ST升高心肌梗塞,不稳定性心痛/非ST升高心肌梗塞的患者,以及接受皮肤冠状动脉干预的患者.
- 评估了每个常规风险因素的患病率和存在的因素数量,在性别和年龄组之间进行比较.
主要成果:
- 显著的大多数心血管疾病患者至少具有一种常规风险因素:84.6%的女性和80.6%的男性.
- 在较年轻的患者群体和患有不稳定性胸痛或接受PCI的患者中,只有10-15%缺乏四种常规危险因素.
- 吸烟是男性早期心脏病的关键因素,而吸烟和糖尿病对女性来说都很重要. 吸烟将心血管疾病发病年龄减少约10年.
结论:
- 与普遍认为的相反,80-90%的冠心病患者确实具有传统的危险因素.
- 虽然非传统因素和遗传学有必要进行研究,但临床实践和公共卫生倡议必须强烈关注传统的风险因素和相关的生活方式行为.
- 强调传统的风险因素对于减少心脏病的流行病至关重要.
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