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创伤后应激障碍与心血管疾病之间的流行病学联系:证据,机制和临床影响
Malik K Al-Ariki1, Ivan Karpenko2, Grigorii Esion3
1Department of Hospital Surgery, Peoples' Friendship University of Russia, Moscow, RUS.
创伤后应激障碍 (PTSD) 是心血管疾病 (CVD) 的重要危险因素. 在心血管保健中解决PTSD对于预防和改善患者的治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 创伤后应激障碍 (PTSD) 是心血管疾病 (CVD) 的独立风险因素.
- 目前的心血管预防策略很少包括PTSD查或管理.
- 创伤后应激障碍和心血管疾病之间的联系是双向的,影响预后和康复.
研究的目的:
- 审查有关PTSD和CVD之间的联系的流行病学证据.
- 探索将PTSD和CVD联系在一起的生物和行为机制.
- 确定治疗心血管疾病患者PTSD的临床影响和未来研究方向.
主要方法:
- 流行病学研究的系统审查.
- 综合各种人群中关于PTSD-CVD关联的证据.
- 对生物,行为和临床因素的分析.
主要成果:
- 在PTSD和高血压,冠状动脉疾病,心肌梗塞,中风,心力衰竭和心血管死亡率增加的风险之间发现了一致的关联.
- 机制包括自主失调,HPA轴激活,炎症,内皮功能障碍,代谢障碍和不健康的行为.
- 创伤后应激障碍影响治疗坚持,心脏康复,并需要创伤知情护理.
结论:
- 将PTSD评估和创伤信息护理整合到心血管环境中是必不可少的.
- 针对PTSD的干预措施可能会降低心血管风险.
- 需要对机制,多样化的人口和综合护理模式进行进一步的研究.
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