Buttar Harpal S, Li Timao, Ravi Nivedita
Bureau of Metabolism, Oncology and Reproductive Sciences, Therapeutic Products Directorate, Health Canada, Ottawa, Ontario.
Exp Clin Cardiol. 2005 Winter;10(4):229-49.
Hypertension, myocardial infarction, atherosclerosis, arrhythmias and valvular heart disease, coagulopathies and stroke, collectively known as cardiovascular diseases (CVDs), contribute greatly to the mortality, morbidity and economic burden of illness in Canada and in other countries. It has been estimated that over four million Canadians have high blood pressure, a comorbid condition that doubles or triples the risk of CVD. According to the Heart and Stroke Foundation of Canada, CVDs caused 36% of deaths in 2001 and were responsible for 18% of the total hospital costs in Canada. The majority of Canadians exhibit at least one CVD-related risk factor, such as tobacco smoking, physical inactivity, diabetes, obesity, hypertension, a lack of daily fruit and vegetable consumption, and psychosocial factors, making these people more prone to developing a serious CVD-related illness in the future. It is therefore important that CVD-related causes and concerns be addressed. Given the scope and prevalence of CVDs, it is obvious that a population health approach - 'prevention is better than cure' - would be the most appropriate model to adopt to deal with this ubiquitous health problem and to reduce the costs of hospitalization, long-term medication and rehabilitation. The focus of the present review is to evaluate and compare the results of epidemiological, experimental and clinical studies, reporting on the influence of physical activity, dietary intervention, obesity and cigarette smoking on cardiovascular health and the prevention of CVDs. The prophylactic measures must be dealt with collectively because there is overwhelming evidence that the occurrence of CVDs can be reduced by approximately 80% by making lifestyle modifications. The preventive strategies against CVDs must be targeted at a primary health promotion level before some of the important underlying causes of CVD seriously afflict a person or a population at large. Such preventive approaches would help in reducing not only employee absenteeism but also the hospital and drug costs burdening the health care systems of both developed and developing countries.
高血压、心肌梗死、动脉粥样硬化、心律失常和心脏瓣膜病、凝血障碍和中风，统称为心血管疾病（CVDs），在加拿大和其他国家，这些疾病极大地导致了死亡率、发病率和疾病经济负担。据估计，超过400万加拿大人患有高血压，这种合并症会使心血管疾病风险增加一倍或两倍。根据加拿大心脏与中风基金会的数据，2001年心血管疾病导致了36%的死亡，占加拿大医院总费用的18%。大多数加拿大人至少表现出一种与心血管疾病相关的风险因素，如吸烟、缺乏体育锻炼、糖尿病、肥胖、高血压、每日水果和蔬菜摄入量不足以及社会心理因素，这使得这些人未来更易患严重的心血管疾病相关病症。因此，解决与心血管疾病相关的病因和问题很重要。鉴于心血管疾病的范围和普遍性，显然，一种群体健康方法——“预防胜于治疗”——将是应对这一普遍存在的健康问题并降低住院、长期用药和康复成本的最合适模式。本综述的重点是评估和比较流行病学、实验和临床研究的结果，报告体育活动、饮食干预、肥胖和吸烟对心血管健康及心血管疾病预防的影响。必须综合处理预防措施，因为有大量证据表明，通过改变生活方式可将心血管疾病的发生率降低约80%。针对心血管疾病的预防策略必须在心血管疾病一些重要潜在病因严重影响个人或广大人群之前，就以初级健康促进为目标。这种预防方法不仅有助于减少员工旷工，还能减轻发达国家和发展中国家医疗保健系统的医院和药物成本负担。
