Cardiovascular Research Center, University of Turku and Turku University Hospital, Turku, Finland.
Curr Opin Cardiol. 2013 Sep;28(5):569-74. doi: 10.1097/HCO.0b013e3283642882.
This review provides an overview of recent findings concerning the cardiovascular effects of childhood exposure to environmental tobacco smoke (ETS).
Epidemiological studies have shown that childhood ETS exposure is associated with increased occurrence of several cardiovascular risk factors, including obesity, elevated blood pressure, dyslipidemia and metabolic syndrome. Several cross-sectional analyses have found that ETS adversely affects arterial structure (increased intima-media thickness) and function (decreased elasticity and endothelial function). In addition, recent findings suggest that individuals exposed in childhood have significantly reduced brachial artery endothelial function 20 years later in adulthood. Importantly, this effect could not be explained by adult risk factor levels or smoking behaviors. So far, results from intervention studies to promote parental smoking cessation have been disappointing, with an average success rate of less than 25% in intervention studies.
Childhood ETS exposure is strongly associated with both cardiovascular risk factors and subclinical markers of atherosclerosis. As present, intervention strategies for parental smoking cessation seem inadequate; there is an urgent need for innovative intervention strategies to protect children from the detrimental effects of ETS.
本文综述了近年来有关儿童期接触环境烟草烟雾(ETS)对心血管影响的研究结果。
流行病学研究表明,儿童期 ETS 暴露与多种心血管危险因素的发生增加有关,包括肥胖、血压升高、血脂异常和代谢综合征。一些横断面分析发现,ETS 对动脉结构(内膜-中层厚度增加)和功能(弹性降低和内皮功能障碍)均有不良影响。此外,最近的研究结果表明,儿童时期暴露于 ETS 的个体,在成年后 20 年内,肱动脉内皮功能显著降低。重要的是,这种影响不能用成人风险因素水平或吸烟行为来解释。到目前为止,促进父母戒烟的干预研究结果令人失望,干预研究中的平均成功率低于 25%。
儿童期 ETS 暴露与心血管危险因素和动脉粥样硬化的亚临床标志物密切相关。目前,父母戒烟的干预策略似乎还不够充分;迫切需要创新的干预策略来保护儿童免受 ETS 的有害影响。