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少数族裔女性冠状动脉疾病的预防、检测与管理

Prevention, Detection and Management of Coronary Artery Disease in Minority Females.

作者信息

Bullock-Palmer Renée P

机构信息

1. Deborah Heart and Lung Center, Browns Mills, New Jersey.

出版信息

Ethn Dis. 2015 Nov 5;25(4):499-506. doi: 10.18865/ed.25.4.499.

Abstract

BACKGROUND AND SIGNIFICANCE

Heart disease is the leading cause of death for women living in the United States; this disease claims more female lives than all cancers combined. Additionally, according to the Centers of Disease Control data between the years 1979 and 2006, while cardiac-related mortality among men decreased significantly, only a modest decline was found among women. This disparity is greatest among minority females including Blacks and Hispanics who have an even greater prevalence of CVD and its risk factors.

PREVENTION

There are several risk factors for coronary artery disease (CAD). Modifiable risk factors include: tobacco smoking, hypertension, diabetes, hyperlipidemia, obesity and physical inactivity. The prevention of CAD is grounded in decreasing or removing these modifiable risk factors.

DETECTION

Accurately diagnosing CAD is dependent on an accurate assessment of the patient's pre-test probability to determine the best diagnostic approach to pursue. The patient's functional status, resting EKG and cardiac risk factors also assist in determining the best non-invasive cardiac test to pursue.

MANAGEMENT

The goals and mainstay in the management of minority females with stable CAD includes surveillance for CAD symptoms, management of hypertension, diabetes mellitus and hyperlipidemia, as well as encouraging healthy habits.

CONCLUSION

Heart disease remains the leading cause of death in minority females. Providers must be diligent to aggressively decrease patients' cardiovascular risk and, when patients do present with cardiovascular symptoms, providers must be aggressive in accurately diagnosing and treating these patients to decrease cardiac morbidity and mortality.

摘要

背景与意义

心脏病是美国女性的首要死因;死于这种疾病的女性比死于所有癌症的女性总和还多。此外,根据疾病控制中心1979年至2006年的数据,男性心脏相关死亡率显著下降,而女性仅略有下降。这种差异在少数族裔女性中最为明显,包括黑人和西班牙裔女性,她们患心血管疾病(CVD)及其危险因素的比例更高。

预防

冠状动脉疾病(CAD)有多种危险因素。可改变的危险因素包括:吸烟、高血压、糖尿病、高脂血症、肥胖和缺乏身体活动。CAD的预防基于减少或消除这些可改变的危险因素。

检测

准确诊断CAD取决于对患者检测前概率的准确评估,以确定最佳的诊断方法。患者的功能状态、静息心电图和心脏危险因素也有助于确定最佳的非侵入性心脏检查方法。

管理

对患有稳定CAD的少数族裔女性进行管理的目标和主要内容包括监测CAD症状、管理高血压、糖尿病和高脂血症,以及鼓励健康生活习惯。

结论

心脏病仍然是少数族裔女性的首要死因。医疗服务提供者必须积极努力降低患者的心血管风险,当患者出现心血管症状时,医疗服务提供者必须积极准确地诊断和治疗这些患者,以降低心脏发病率和死亡率。

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