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27 个国家的冠心病患者生活方式及对心血管危险因素控制的影响:欧洲心脏病学会 ESC-EORP EUROASPIRE V 注册研究结果。

Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry.

机构信息

1 European Society of Cardiology, Sophia Antipolis, France.

2 National Heart and Lung Institute, Imperial College London, UK.

出版信息

Eur J Prev Cardiol. 2019 May;26(8):824-835. doi: 10.1177/2047487318825350. Epub 2019 Feb 10.

Abstract

AIMS

The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice.

DESIGN

A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries.

METHODS

Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later.

RESULTS

A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%.

CONCLUSION

A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.

摘要

目的

本研究旨在确定在日常实践中是否遵循了欧洲心脏病学会(ESC)和欧洲心脏调查者协会(EORP)联合制定的二级心血管预防指南。

设计

在 27 个国家的 81 个地区的 131 个中心进行了一项横断面 ESC-EORP 调查(EUROASPIRE V)。

方法

对确诊的冠状动脉事件或介入治疗后的患者进行访谈,并在 6 个月后进行检查。

结果

共对 8261 例患者(女性占 26%)进行了访谈。19%的患者吸烟,其中 55%为持续吸烟者,38%为肥胖(体重指数≥30kg/m²),59%为中心性肥胖(腰围:男性≥102cm;女性≥88cm),66%的患者每周运动<30 分钟,<5 次。42%的患者血压≥140/90mmHg(如果糖尿病患者则≥140/85mmHg),71%的患者低密度脂蛋白胆固醇≥1.8mmol/L(≥70mg/dL),29%的患者报告患有糖尿病。患者使用的心脏保护药物有:抗血小板药物 93%,β受体阻滞剂 81%,血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂 75%,他汀类药物 80%。

结论

大多数冠状动脉疾病患者的生活方式不健康,存在吸烟、饮食和久坐不动等行为,这对主要心血管危险因素产生不利影响。大多数患者未能达到血压、低密度脂蛋白胆固醇和血糖目标。心血管预防需要由跨学科医疗团队提供现代预防心脏病学方案,以管理生活方式和危险因素的各个方面,从而降低心血管事件复发的风险。

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