心血管风险因素的变化与心血管事件的关联
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
概括
随着时间的推移,改善心血管健康指标并没有持续降低心血管疾病 (CVD) 风险. 维持中等或高心血管健康有好处,但仅仅健康类别的变化并不是心血管疾病发病率的可靠预测指标.
科学领域:
- 心血管健康
- 流行病学
- 公共卫生
背景情况:
- 理想的心血管健康与心血管疾病 (CVD) 的风险降低有关.
- 之前的研究通常依赖于单一的心血管健康指标.
- 了解心血管健康的变化对心血管疾病发病率的影响至关重要.
研究的目的:
- 研究心血管健康状况随时间变化与发生心血管疾病的风险之间的关联.
- 分析不同心血管健康轨迹对心血管疾病结果的影响.
主要方法:
- 英国的一项前性队列研究 (惠特霍尔II).
- 使用美国心脏协会7项指标 (吸烟,BMI,体力活动,饮食,血压,禁食葡萄糖,总胆固醇) 评估心血管健康,分为低,中等或高.
- 10年内心血管健康变化的分析 (1985/1988年至1997/1999年) 和到2017年的心血管疾病随访.
主要成果:
- 在之前没有心血管疾病的6326名参与者中,在中位数为18. 9年的随访期间发生了114起心血管疾病事件.
- 持续低心血管健康与较高的心血管疾病发病率 (每1000人/ 年9. 6) 相关.
- 与持续低健康相比,持续中度,持续中度至高,持续高至中度和持续高的心血管健康类别显示心血管疾病风险明显较低.
结论:
- 在心血管健康类别的变化方向和心血管疾病风险之间没有发现一致的关系.
- 保持中等或高水平的心血管健康似乎比具体的变化轨迹更为重要.
- 这些发现强调了持续的理想心血管健康指标对于长期预防心血管疾病的重要性.
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