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南亚儿童心血管危险因素:成人心血管疾病流行的一个担忧原因。

Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic.

作者信息

Prasad Duggirala Sivaram, Kabir Zubair, Dash Ashok Kumar, Das Bhagabati Charan

机构信息

Sudhir Heart Centre, Dharmanagar, Berhampur, Orissa, India.

出版信息

Ann Pediatr Cardiol. 2011 Jul;4(2):166-71. doi: 10.4103/0974-2069.84663.

Abstract

Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative.

摘要

在西方世界,儿童心血管危险因素正以惊人的速度增加。然而,关于南亚儿童心血管危险因素的信息有限。本综述旨在总结此类证据。与高加索人相比,南亚人成人心血管疾病(CVD)的发病年龄几乎早十年,这一点很显著。我们使用脂质异常、高血压、高血糖、吸烟、肥胖、缺乏身体活动和不健康饮食习惯等特定检索词,主要在PubMed、Embase和Cochrane图书馆中检索已发表的文献。动脉粥样硬化性心血管疾病过程在儿童早期就开始了,并在整个生命过程中受到遗传因素、潜在可改变的危险因素和环境暴露的影响。到2020年,80%的成人心血管疾病负担将落在发展中国家。初级预防的概念正迅速成为遏制成人心血管疾病流行的必要预防工具。现已有关于心血管健康的既定指南和经证实的预防策略;然而,这些措施的实施总是不够坚决。针对成人的综合筛查和预测工具可以针对南亚人群进行调整并在儿童中进行验证。南亚儿童在更早阶段出现心血管危险因素的风险可能更高,因此,及时干预势在必行。

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