Said Sarmad, Mukherjee Debabrata, Whayne Thomas F
Department of Internal Medicine, Division of Cardiovascular Disease, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, 4800 Alberta Avenue, El Paso, Texas, USA 79905.
Curr Vasc Pharmacol. 2016;14(5):415-425. doi: 10.2174/1570161114666160722121615.
Cardiovascular (CV) disease is the most common cause of morbidity and mortality worldwide, particularly in the presence of the metabolic syndrome (MetS). Classifications and treatment of the MetS have recently been redefined. While the majority of the cardiac components such as hypertension, diabetes mellitus (DM) and dyslipidemia (DLD) are objectively measurable elements, a few disparities among the definitions have to be considered that can variably modify diagnosis, treatment and prevention. Non-cardiac factors such as liver disease (including, but not limited to, alcoholic and non-alcoholic steatosis/hepatitis), renal disease, severe obesity, polycystic ovarian syndrome and obstructive sleep apnea (OSA), may have independent or synergistic relationship with complementary cardiac MetS elements, and these additional risk factors may have an incremental adverse impact on CV outcome. The combination of all these factors potentiates the adverse significance on CV events. MetS not only increases morbidity and mortality but also has economic ramifications for the healthcare system. Prevention of CV disease includes primary and secondary aspects. Besides overall advances to provide optimal care for hypertension, diabetes, and dyslipidemia, early-targeted inventions to diagnose, treat and prevent OSA, and severe obesity, are needed.
心血管(CV)疾病是全球发病和死亡的最常见原因,尤其是在存在代谢综合征(MetS)的情况下。最近对MetS的分类和治疗进行了重新定义。虽然大多数心脏相关因素,如高血压、糖尿病(DM)和血脂异常(DLD)是客观可测量的要素,但必须考虑定义之间的一些差异,这些差异可能会不同程度地改变诊断、治疗和预防。非心脏因素,如肝脏疾病(包括但不限于酒精性和非酒精性脂肪变性/肝炎)、肾脏疾病、严重肥胖、多囊卵巢综合征和阻塞性睡眠呼吸暂停(OSA),可能与心脏MetS的补充要素存在独立或协同关系,这些额外的危险因素可能会对心血管结局产生额外的不利影响。所有这些因素的综合作用增强了对心血管事件的不利影响。MetS不仅会增加发病率和死亡率,还会对医疗系统产生经济影响。心血管疾病的预防包括一级预防和二级预防。除了在为高血压、糖尿病和血脂异常提供最佳护理方面取得的总体进展外,还需要早期针对性的干预措施来诊断、治疗和预防OSA以及严重肥胖。