Bloetzer Clemens, Bovet Pascal, Suris Joan-Carles, Simeoni Umberto, Paradis Gilles, Chiolero Arnaud
1Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland.
2Division of Chronic Diseases, Institute of social and preventive medicine, Lausanne University Hospital, Lausanne, Switzerland.
Public Health Rev. 2015 Nov 5;36:9. doi: 10.1186/s40985-015-0011-2. eCollection 2015.
Cardiovascular diseases (CVD) are the leading cause of death worldwide. Individual detection and intervention on CVD risk factors and behaviors throughout childhood and adolescence has been advocated as a strategy to reduce CVD risk in adulthood. The U.S. National Heart, Lung, and Blood Institute (NHLBI) has recently recommended universal screening of several risk factors in children and adolescents, at odds with several recommendations of the U.S. Services Task Force and of the U.K. National Screening committee. In the current review, we discuss the goals of screening for CVD risk factors (elevated blood pressure, abnormal blood lipids, diabetes) and behaviors (smoking) in children and appraise critically various screening recommendations. Our review suggests that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormal blood glucose, or smoking in children and adolescents. Targeted screening of these risk factors could be useful but specific screening strategies have to be evaluated. Research is needed to identify target populations, screening frequency, intervention, and follow-up. Meanwhile, efforts should rather focus on the primordial prevention of CVD risk factors and at maintaining a lifelong ideal cardiovascular health through environmental, policy, and educational approaches.
心血管疾病（CVD）是全球首要死因。提倡在儿童期和青少年期对心血管疾病风险因素及行为进行个体检测和干预，以此作为降低成年期心血管疾病风险的一项策略。美国国立心肺血液研究所（NHLBI）最近建议对儿童和青少年的多种风险因素进行普遍筛查，这与美国卫生保健服务任务组以及英国国家筛查委员会的多项建议不一致。在本综述中，我们讨论了筛查儿童心血管疾病风险因素（血压升高、血脂异常、糖尿病）及行为（吸烟）的目标，并对各种筛查建议进行了批判性评估。我们的综述表明，没有令人信服的证据支持对儿童和青少年的血压升高、血脂异常、血糖异常或吸烟进行普遍筛查。针对这些风险因素进行有针对性的筛查可能有用，但具体的筛查策略必须进行评估。需要开展研究以确定目标人群、筛查频率、干预措施及随访方式。与此同时，应将努力重点放在对心血管疾病风险因素的一级预防上，并通过环境、政策和教育手段维持终身理想的心血管健康状态。
