风湿性疾病患者的心血管疾病风险
Cardiovascular Disease Risk in Patients with Rheumatic Diseases.
作者信息
Mackey Rachel H, Kuller Lewis H, Moreland Larry W
机构信息
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh, 542 Bellefield Professional Building, 130 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Room 550, Bellefield Professional Building, 130 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
出版信息
Clin Geriatr Med. 2017 Feb;33(1):105-117. doi: 10.1016/j.cger.2016.08.008.
Evidence suggests the greater than 1.5 increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) is related to an accelerated burden of subclinical atherosclerosis that develops before the diagnosis of RA. Dyslipidemia in RA is better quantified by lipoproteins and apolipoproteins than cholesterol levels. Current risk factors likely underestimate CVD risk partly by underestimating prior risk factor levels. To reduce CVD risk in RA, control disease activity and aggressively treat CVD risk factors. Some of the two-fold higher risk of heart failure and total mortality in RA may be due to myocardial disease caused by inflammation.
有证据表明，类风湿关节炎（RA）患者患心血管疾病（CVD）的风险增加超过1.5倍，这与在RA诊断之前就已出现的亚临床动脉粥样硬化负担加速有关。与胆固醇水平相比，通过脂蛋白和载脂蛋白能更好地量化RA中的血脂异常。目前的风险因素可能部分通过低估既往风险因素水平而低估了CVD风险。为降低RA患者的CVD风险，应控制疾病活动并积极治疗CVD风险因素。RA中心力衰竭和总死亡率高出两倍的部分原因可能是炎症引起的心肌疾病。
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