Jarvis Carolyn M, Hayman Laura L, Braun Lynne T, Schwertz Dorie W, Ferrans Carol Estwing, Piano Mariann R
Department of Medical-Surgical Nursing, University of Illinois at Chicago, IL 60612, USA.
J Cardiovasc Nurs. 2007 Nov-Dec;22(6):429-35. doi: 10.1097/01.JCN.0000297387.21626.88.
Cardiovascular disease (CVD) is a leading cause of mortality among alcohol-dependent people; however, minimal data exist on the CVD risk factor profile in this high-risk population. The purpose of this study was to examine the prevalence and clustering of traditional and novel CVD risk factors, including components of the metabolic syndrome, in nicotine- and alcohol-dependent adults.
Participants (n = 46; 61% men; 87% white), who were a consecutive series of eligible adults (19-56 years of age; mean, 34.8 +/- 1.4 years; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-classified alcoholic; abstinent for <or=7 days), were assessed on entry to a residential drug treatment facility. Cardiovascular disease risk factors were measured using standardized protocols and interview-administered, self-report inventories adapted from epidemiological studies. Dyslipidemia and metabolic syndrome were identified using Adult Treatment Panel III criteria; hypertension was classified by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria. Enzymatic, colorimetric, and immunochemiluminometric techniques were used to measure plasma lipids, homocysteine, and high-sensitivity C-reactive protein, respectively.
Dyslipidemia was identified in 74% of participants; 54% were overweight or obese (body mass index, >or=25 kg/m2); 61% were physically inactive (<1,000 kcal/wk); and 61% had some form of hypertension. In addition, 54% had increased homocysteine values; high-sensitivity C-reactive protein was elevated in 28%; and 22% of the participants met criteria for metabolic syndrome. In this study of the CVD risk profile among alcoholics, subjects were found to have an average of 3 CVD risk factors in addition to cigarette smoking. This prevalence and clustering of potentially modifiable risk factors in young, nicotine-dependent alcoholics indicate the need for aggressive risk reduction focused on prevention of CVD.
心血管疾病（CVD）是酒精依赖者死亡的主要原因；然而，关于这一高危人群心血管疾病危险因素状况的数据极少。本研究的目的是调查尼古丁和酒精依赖成年人中传统及新型心血管疾病危险因素（包括代谢综合征各组分）的患病率及聚集情况。
研究对象（n = 46；61%为男性；87%为白人）为连续入选的符合条件的成年人（年龄19 - 56岁；平均34.8±1.4岁；根据《精神疾病诊断与统计手册》第四版分类为酒精依赖者；戒酒时间≤7天），在进入住院戒毒治疗机构时接受评估。心血管疾病危险因素采用标准化方案进行测量，并使用从流行病学研究改编而来的访谈式自填问卷进行评估。血脂异常和代谢综合征根据成人治疗小组第三次报告标准进行判定；高血压按照美国预防、检测、评估与治疗高血压联合委员会标准进行分类。分别采用酶法（比色法）和免疫化学发光法测量血浆脂质、同型半胱氨酸和高敏C反应蛋白。
74%的研究对象存在血脂异常；54%超重或肥胖（体重指数≥25 kg/m²）；61%身体活动不足（每周消耗热量<1000千卡）；61%患有某种形式高血压。此外，54%的研究对象同型半胱氨酸值升高；28%的研究对象高敏C反应蛋白升高；22%的研究对象符合代谢综合征标准。在这项关于酗酒者心血管疾病风险状况的研究中，发现除吸烟外，研究对象平均存在3种心血管疾病危险因素。在年轻的尼古丁依赖酗酒者中，这些潜在可改变危险因素的患病率及聚集情况表明，有必要积极采取降低风险措施以预防心血管疾病。
