M Nilsson Peter
Professor, Lund University, Malmö, Sweden.
Eur Endocrinol. 2015 Apr;11(1):26-31. doi: 10.17925/EE.2015.11.01.26. Epub 2015 Apr 11.
Cardiovascular disease (CVD) is a prevalent condition in the elderly, often associated with metabolic disturbance and type 2 diabetes. For a number of years, research dedicated to understand atherosclerosis dominated, and for many good reasons, this pathophysiological process being proximal to the CVD events. In recent years, research has been devoted to an earlier stage of vascular pathology named arteriosclerosis (arterial stiffness) and the new concept of early vascular ageing (EVA), developed by a group of mostly European researchers. This overview describes recent developments in research dedicated to EVA and new emerging aspects found in studies of families at high cardiovascular risk. There are new aspects related to genetics, telomere biology and the role of gut microbiota. However, there is still no unifying definition available of EVA and no direct treatment, but rather only recommendations for conventional cardiovascular risk factor control. New interventions are being developed - not only new antihypertensive drugs, but also new drugs for vascular protection - the selective angiotensin-II (AT2) agonist Compound 21 (C21). Human studies are eagerly awaited. Even new functional food products could have the potential to positively influence cardiometabolic regulation, to be confirmed.
心血管疾病（CVD）在老年人中很常见，常与代谢紊乱和2型糖尿病相关。多年来，致力于了解动脉粥样硬化的研究占据主导地位，而且有诸多充分理由，因为这一病理生理过程与心血管疾病事件密切相关。近年来，研究方向转向了血管病理学的早期阶段，即动脉硬化（动脉僵硬度）以及由一群主要来自欧洲的研究人员提出的早期血管衰老（EVA）这一新概念。本综述描述了致力于EVA研究的最新进展以及在心血管高风险家族研究中发现的新出现的方面。这些新方面涉及遗传学、端粒生物学以及肠道微生物群的作用。然而，目前仍没有关于EVA的统一界定，也没有直接的治疗方法，而只有针对传统心血管危险因素控制的建议。正在研发新的干预措施——不仅有新的抗高血压药物，还有用于血管保护的新药——选择性血管紧张素-II（AT2）激动剂化合物21（C21）。人们热切期待人体研究结果。甚至新型功能性食品也可能有积极影响心脏代谢调节的潜力，有待证实。
