Kaar Jill L, Luberto Christina M, Campbell Kirsti A, Huffman Jeff C
Jill L Kaar, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045, United States.
World J Cardiol. 2017 May 26;9(5):396-406. doi: 10.4330/wjc.v9.i5.396.
Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large.
许多健康行为，包括体育活动、饮食、吸烟和睡眠，在预防心血管疾病（CVD）的发生和发展中起着重要作用。在这些行为中，睡眠可能起着关键作用，但与其他行为相比，对其研究相对较少，针对CVD的精心设计的睡眠干预研究也很少。此外，尽管这些行为往往相互关联，但干预措施往往侧重于改变一种健康行为，而不是同时对多种行为进行干预。从抑郁到积极情绪的心理因素也可能对这些健康行为以及最终对CVD产生重大影响。在本综述中，我们总结了关于睡眠和其他心脏健康行为对CVD发病和预后影响的现有文献。我们还描述了可能促进这些行为的干预措施，从动机访谈和认知行为疗法等既定干预措施，到专注于正念和其他积极心理因素的更新颖方法。最后，我们概述了针对可能影响心脏健康的精神疾病（如抑郁症）患者的人群健康层面的护理管理方法，并讨论了它们在改善心理健康、促进健康行为和降低CVD相关风险方面的潜在效用。仍需要做大量工作来更好地理解睡眠和其他健康行为如何独特地导致CVD风险，并且需要更多高质量的旨在改变心脏健康行为的干预研究，以改善个体和广大人群的心血管健康。
