老年人长期脊髓损伤的心血管危险因素。

Cardiovascular Risk Factors Among Older Adults With Long-Term Spinal Cord Injury.

机构信息

Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund; and Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.

Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund; and Department of Neuroscience, Rehabilitation Medicine,, Uppsala University, Uppsala, Sweden.

出版信息

PM R. 2019 Jan;11(1):8-16. doi: 10.1016/j.pmrj.2018.06.008. Epub 2019 Jan 16.

DOI:10.1016/j.pmrj.2018.06.008

PMID:29964213

Abstract

BACKGROUND

Individuals with spinal cord injury (SCI) now live longer, which increases the risk of cardiovascular disease. Knowledge of cardiovascular risk factors amenable to intervention are therefore needed to support their healthy aging.

OBJECTIVE

To describe the occurrence of cardiovascular risk factors among older adults with long-term SCI and investigate the association with sociodemographics and injury characteristics.

DESIGN

Cross-sectional descriptive cohort study.

SETTING

Home settings.

PARTICIPANTS

In total, 123 individuals (71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years.

METHODS

Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS), collected through interviews and assessments during home visits and from medical records.

MAIN OUTCOME MEASURES

Anthropometric measurements, blood pressure, fasting plasma glucose and blood lipids, and data on cardiovascular comorbidity and tobacco use.

RESULTS

One third had a previous diagnosis of hypertension, and 55% presented with a blood pressure ≥ 140/90 mm Hg at the time of assessment. Sixteen percent had a history of diabetes and in 15% fasting glucose levels were ≥ 7 mmol/L. Dyslipidemia was present in 76%, whereas 16% had prediagnosed dyslipidemia. Mean body mass index (BMI) was 27 kg/m and mean waist circumference was 101 cm. When SCI-adjusted BMI cut-off values were used, 93% were considered overweight (BMI ≥22 kg/m ), and 60% had a waist circumference associated with cardiometabolic risk. A total of 16% smoked regularly. The median number of cardiovascular risk factors was 3. No significant associations were found between the total number of risk factors and sociodemographics and injury characteristics.

CONCLUSIONS

The high occurrence of cardiovascular risk factors among older adults with long-term SCI can pose additional consequences to their health. Regular assessments and interventions targeting cardiovascular risk in this population are therefore warranted. Further research is needed to identify modifiable factors associated with their risk profile.

LEVEL OF EVIDENCE

III.

摘要

背景

患有脊髓损伤（SCI）的个体现在寿命更长，这增加了心血管疾病的风险。因此，需要了解可干预的心血管危险因素，以支持他们的健康老龄化。

目的

描述长期 SCI 老年人中心血管危险因素的发生情况，并探讨其与社会人口统计学和损伤特征的关联。

设计

横断面描述性队列研究。

地点

家庭环境。

参与者

共有 123 名参与者（71%为男性，损伤水平 C1-L5，美国脊髓损伤协会损伤量表 A-D），平均年龄 63 岁，平均受伤时间 24 年。

方法

数据来自瑞典脊髓损伤老龄化研究（SASCIS），通过家访中的访谈和评估以及医疗记录收集。

主要观察指标

人体测量学测量、血压、空腹血糖和血脂，以及心血管合并症和吸烟的数据。

结果

三分之一的人以前被诊断患有高血压，55%的人在评估时血压≥140/90mmHg。16%的人有糖尿病病史，15%的人空腹血糖水平≥7mmol/L。血脂异常者占 76%，而 16%的人有血脂异常的预先诊断。平均体重指数（BMI）为 27kg/m，平均腰围为 101cm。当使用 SCI 调整后的 BMI 临界值时，93%的人被认为超重（BMI≥22kg/m），60%的人腰围与代谢风险相关。共有 16%的人定期吸烟。心血管危险因素的中位数为 3 个。危险因素总数与社会人口统计学和损伤特征之间无显著相关性。