Gooding Holly, Johnson Heather M
Departments of Medicine and Pediatrics at Harvard Medical School, Division of Adolescent/Young Adult Medicine at Boston Children's Hospital, and Division of General Internal Medicine at Brigham and Women's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, H4/512 CSC, MC 3248, 600 Highland Avenue, Madison, WI 53792, USA.
Curr Cardiovasc Risk Rep. 2016 Sep;10. doi: 10.1007/s12170-016-0509-2. Epub 2016 Aug 2.
It is well established that atherosclerosis, the pathological basis of cardiovascular disease (CVD), begins in childhood and progresses steadily between the ages of 15 to 35 years. These adolescent and young adult years are also marked by significant physiological, psychological, and sociodemographic changes that impact both CVD risk factor development and CVD prevention and treatment strategies. In this review, we highlight the importance of the prevention of CVD risk factors before they ever occur and the prevention of CVD by treating CVD risk factors in this age group. Although the long time to first CVD event for most young people precludes the availability of clinical trials with hard end-points, findings from epidemiology, health psychology, health services research, and clinical trials with surrogate endpoints are discussed to inform an evidence-based approach to CVD prevention in adolescents and young adults.
动脉粥样硬化作为心血管疾病（CVD）的病理基础，始于儿童期，并在15至35岁之间稳步发展，这一点已得到充分证实。这些青少年和青年时期还具有显著的生理、心理和社会人口学变化，这些变化会影响心血管疾病危险因素的发展以及心血管疾病的预防和治疗策略。在本综述中，我们强调在心血管疾病危险因素出现之前进行预防的重要性，以及通过治疗该年龄组的心血管疾病危险因素来预防心血管疾病的重要性。尽管大多数年轻人首次发生心血管疾病事件的时间间隔很长，无法进行有硬终点的临床试验，但我们仍讨论了流行病学、健康心理学、卫生服务研究以及有替代终点的临床试验的结果，以为青少年和青年心血管疾病预防的循证方法提供依据。
