根据新预防准则的年龄组对心血管疾病的风险分层:一项审查
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
Journal of lipid and atherosclerosis
|June 2, 2023
概括
心血管疾病风险评估需要针对不同年龄组量身定制的方法. 虽然老年人可能面临强化治疗的风险,但年轻人有高的终身风险,需要平衡的预防策略.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 老年病的医生 老年病的医生
背景情况:
- 年龄是心血管疾病 (CVD) 的重要危险因素.
- 目前的心血管疾病风险预测模型将年龄作为一个独立的因素.
- 有效管理心血管疾病风险因素有利于老年人,但密集治疗可能会增加不良事件的风险.
研究的目的:
- 评估特定年龄的心血管疾病预防策略.
- 解决年轻人治疗不足和老年人过度治疗之间的平衡问题.
- 将终身风险和患者特异性因素纳入心血管疾病预防.
主要方法:
- 审查2021年欧洲心脏病学会关于预防心血管疾病的指南.
- 对年龄相关风险分层和治疗建议的分析.
- 考虑年龄以外的因素,包括并发症,虚弱和患者的偏好.
主要成果:
- 2021年ESC指南提出了特定于年龄组的风险分层和治疗建议.
- 在老年人中,强化治疗 (例如,血压,降低葡萄糖) 可以增加诸如跌倒,昏迷和低血糖等不良事件的风险.
- 年轻人10年心血管疾病风险低,但终身风险高,这表明需要考虑早期预防.
结论:
- 对所有年龄组来说,平衡的,个性化的心血管疾病预防方法至关重要.
- 根据年龄的风险分层应该指导,而不是授权,治疗的开始.
- 诸如终身风险,治疗益处/危害,并发症,脆弱性和患者偏好等因素对于个性化的初级预防策略至关重要.
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