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新诊断为阻塞性冠状动脉疾病的中青年成年人的心血管危险因素控制与生活方式因素

Cardiovascular Risk Factor Control and Lifestyle Factors in Young to Middle-Aged Adults with Newly Diagnosed Obstructive Coronary Artery Disease.

作者信息

Garshick Michael S, Vaidean Georgeta D, Vani Anish, Underberg James A, Newman Jonathan D, Berger Jeffrey S, Fisher Edward A, Gianos Eugenia

机构信息

Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA,

Center for the Prevention of Cardiovascular Disease, New York University Langone Health, New York City, New York, USA.

出版信息

Cardiology. 2019;142(2):83-90. doi: 10.1159/000498891. Epub 2019 May 10.

Abstract

BACKGROUND

While progress in the prevention of cardiovascular disease (CVD) has been noted over the past several decades, there are still those who develop CVD earlier in life than others.

OBJECTIVE

We investigated traditional and lifestyle CVD risk factors in young to middle-aged patients compared to older ones with obstructive coronary artery disease (CAD).

METHODS

A retrospective analysis of patients with a new diagnosis of obstructive CAD undergoing coronary intervention was performed. Young to middle-aged patients were defined as those in the youngest quartile (n = 281, mean age 50 ± 6 years, 81% male) compared to the other three older quartiles combined (n = 799, mean age 69 ± 7.5 years, 71% male). Obstructive CAD was determined by angiography.

RESULTS

Young to middle-aged patients compared to older ones were more likely to be male (p < 0.01), smokers (21 vs. 9%, p < 0.001), and have a higher body mass index (31 ± 6 vs. 29 ± 6 kg/m2, p < 0.001). Younger patients were less likely to eat fruits, vegetables, and fish and had fewer controlled CVD risk factors (2.7 ± 1.2 vs. 3.0 ± 1.0, p < 0.001). Compared to older patients, higher levels of psychological stress (aOR 1.6, 95% CI 1.1-2.4), financial stress (aOR 1.8, 95% CI 1.3-2.5), and low functional capacity (aOR 3.3, 95% CI 2.4-4.5) were noted in the young to middle-aged population as well.

CONCLUSION

Lifestyle in addition to traditional CVD risk factors should be taken into account when evaluating risk for development of CVD in a younger population.

摘要

背景

尽管在过去几十年中已注意到心血管疾病(CVD)预防方面取得了进展,但仍有一些人比其他人更早地患上心血管疾病。

目的

我们调查了年轻至中年冠心病患者与老年冠心病患者相比的传统和生活方式心血管疾病风险因素。

方法

对新诊断为阻塞性冠心病并接受冠状动脉介入治疗的患者进行回顾性分析。年轻至中年患者定义为年龄最小四分位数的患者(n = 281,平均年龄50±6岁,81%为男性),与其他三个年龄较大的四分位数患者合并组(n = 799,平均年龄69±7.5岁,71%为男性)进行比较。阻塞性冠心病通过血管造影确定。

结果

与老年患者相比,年轻至中年患者更可能为男性(p < 0.01)、吸烟者(21%对9%,p < 0.001),且体重指数更高(31±6对29±6 kg/m²,p < 0.001)。年轻患者食用水果、蔬菜和鱼类的可能性较小,且心血管疾病风险因素得到控制的较少(2.7±1.2对3.0±1.0,p < 0.001)。与老年患者相比,年轻至中年人群中心理压力水平较高(调整后比值比1.6,95%置信区间1.1 - 2.4)、财务压力较高(调整后比值比1.8,95%置信区间1.3 - 2.5)以及功能能力较低(调整后比值比3.3,95%置信区间2.4 - 4.5)也较为明显。

结论

在评估年轻人群发生心血管疾病的风险时,除了传统的心血管疾病风险因素外,还应考虑生活方式。

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