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成年早期的高脂血症增加了冠状动脉心脏病的长期风险

Ann Marie Navar-Boggan¹, Eric D Peterson², Ralph B D'Agostino²

¹From the Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.-B., E.D.P., B.N., M.J.P.); Boston University, Boston, MA (R.B.D.); and Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University Health Centre, Montreal, Canada (A.D.S.). navar006@mc.duke.edu michael.pencina@duke.edu.

|January 28, 2015

概括

在年轻人中长期暴露于中度超脂血症显著增加了未来冠状动脉心脏病 (CHD) 的风险. 目前的指导方针可能会忽略那些可能受益于高胆固醇血症早期干预的个人.

科学领域:

心脏病学心脏病学
预防医学预防医学
公共卫生公共卫生

背景情况:

目前对于他类药物治疗的胆固醇指南主要关注10年心血管风险.
许多患有中度高脂血症的年轻人不符合这些标准.
早期成年期高胆固醇血持续时间对未来冠心病 (CHD) 风险的影响尚未完全理解.

研究的目的:

评估早期成年期高脂血症暴露的持续时间与随后的心脏病风险之间的关联.
为了确定是否累积暴露在高胆固醇血症中,即使在中度水平,预测未来的心血管事件.

主要方法:

分析了Framingham后代队列 (n=1478) 的数据,这些成年人没有心血管疾病,直到55岁.
检查早期成年期中中度超脂血症 (非高密度脂蛋白胆固醇≥160毫克/分升) 持续时间和随后的心脏病发病率之间的关联.
对其他心脏风险因素进行了统计调整.

主要成果:

慢性心血管疾病的发病率在55岁时随着长时间的高脂血症暴露显著增加 (4.4%没有暴露,8.1%在1-10年,16.5%在11-20年;P<0.001).
这种关联在调整其他危险因素后仍然存在 (HR,每十年高脂血症的1.39).
85%的患有长期高脂血症的年轻人在40岁时不符合他类药物的标准,但累积暴露仍然是55岁时心血管疾病风险的重要预测因素.

结论:

在年轻成年期,累积暴露于高脂血症与剂量依赖的未来心脏病风险增加有关.
长期中度高胆固醇血症的成年人患心脏病风险较高,可能会从更积极的初级预防策略中受益.
在年轻人中,长期的高脂血症管理对于减轻未来心血管事件至关重要.

关键词:

冠状动脉疾病是一种冠状动脉疾病.过高脂血症是什么意思危险的风险危险的风险

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