Department of Cardiovascular Medicine, Humanitas Research Hospital, Milan, Italy.
Humanitas University, Via Manzoni 56, Rozzano, Milan, Italy.
Clin Rev Allergy Immunol. 2018 Dec;55(3):254-270. doi: 10.1007/s12016-017-8624-5.
The developments that have taken place in recent decades in the diagnosis and therapy of a number of diseases have led to improvements in prognosis and life expectancy. As a consequence, there has been an increase in the number of patients affected by chronic diseases and who can face new pathologies during their lifetime. The prevalence of chronic heart failure, for example, is approximately 1-2% of the adult population in developed countries, rising to ≥10% among people >70 years of age; in 2015, more than 85 million people in Europe were living with some sort of cardiovascular disease (CVD) (Lubrano and Balzan World J Exp Med 5:21-32, 5; Takahashi et al. Circ J 72:867-72, 8; Kaptoge et al. Lancet 375:132-40, 9). Chronic disease can become, in turn, a major risk factor for other diseases. Furthermore, several new drugs have entered clinical practice whose adverse effects on multiple organs are still to be evaluated. All this necessarily involves a multidisciplinary vision of medicine, where the physician must view the patient as a whole and where collaboration between the various specialists plays a key role. An example of what has been said so far is the relationship between CVD and chronic inflammatory diseases (CIDs). Patients with chronic CVD may develop a CID within their lifetime, and, vice versa, a CID can be a risk factor for the development of CVD. Moreover, drugs used for the treatment of CIDs may have side effects involving the cardiovascular system and thus may be contraindicated. The purpose of this paper is to investigate the close relationship between these two groups of diseases and to provide recommendations on the diagnostic approach and treatments in light of the most recent scientific data available.
近几十年来，许多疾病的诊断和治疗方面的发展，改善了预后和预期寿命。因此，患有慢性疾病的患者数量增加，他们在一生中可能会面临新的病理问题。例如，慢性心力衰竭在发达国家的成年人中的患病率约为 1-2%，在>70 岁的人群中上升至≥10%；2015 年，欧洲有超过 8500 万人患有某种心血管疾病（CVD）（Lubrano 和 Balzan World J Exp Med 5:21-32, 5；Takahashi 等人Circ J 72:867-72, 8；Kaptoge 等人Lancet 375:132-40, 9）。慢性疾病反过来又可能成为其他疾病的主要危险因素。此外，几种新的药物已经进入临床实践，其对多个器官的不良反应仍有待评估。所有这些都必然需要医学的多学科视角，医生必须将患者视为一个整体，并且各个专家之间的合作起着关键作用。到目前为止所说的一个例子是 CVD 和慢性炎症性疾病（CIDs）之间的关系。慢性 CVD 患者在其一生中可能会患上 CID，反之亦然，CID 也可能是 CVD 发展的危险因素。此外，用于治疗 CIDs 的药物可能会产生涉及心血管系统的副作用，因此可能被禁用。本文旨在探讨这两组疾病之间的密切关系，并根据最新的科学数据提供诊断方法和治疗建议。
