Elisaf M
Department of Internal Medicine, Medical School, University of Ioannina, Ioannina 451 10, Greece.
Curr Med Res Opin. 2001;17(1):18-26.
Cardiovascular disease (CVD) is the main cause of death. Atherosclerosis of coronary arteries is responsible for almost all cases of CVD. The term 'risk factor' describes all those characteristics found in healthy individuals that are independently related to subsequent development of CVD. It includes modifiable biochemical and physiological characteristics, such as hypercholesterolaemia, hypertension, cigarette smoking, diabetes mellitus, obesity and low HDL cholesterol levels, as well as non-modifiable personal characteristics, such as age, gender and family or personal history of early onset CVD. In addition to the 'classic' risk factors mentioned above, several other variables have been implicated as predictors of CVD: left ventricular hypertrophy; infectious agents; markers of inflammation; oxidative stress; and increased levels of fibrinogen, triglycerides, homocysteine and Lp(a)]. However, controversy exists regarding the exact role of these variables in the pathogenesis of atherosclerosis. Furthermore, there are no conclusive data showing that the modification of these variables is associated with a decrease in the incidence of cardiovascular events. Nevertheless, these 'new' risk factors should be taken into account in patients with CVD without established risk factors.
心血管疾病（CVD）是主要的死亡原因。冠状动脉粥样硬化几乎是所有心血管疾病病例的病因。“危险因素”一词描述了在健康个体中发现的所有那些与心血管疾病随后发生独立相关的特征。它包括可改变的生化和生理特征，如高胆固醇血症、高血压、吸烟、糖尿病、肥胖和低高密度脂蛋白胆固醇水平，以及不可改变的个人特征，如年龄、性别以及早发性心血管疾病的家族史或个人史。除了上述“经典”危险因素外，还有其他几个变量被认为是心血管疾病的预测指标：左心室肥厚；感染因子；炎症标志物；氧化应激；以及纤维蛋白原、甘油三酯、同型半胱氨酸和脂蛋白（a）水平升高。然而，关于这些变量在动脉粥样硬化发病机制中的确切作用存在争议。此外，没有确凿的数据表明改变这些变量与心血管事件发生率的降低有关。尽管如此，对于没有既定危险因素的心血管疾病患者，应考虑这些“新”危险因素。
