Ciurtin Coziana, Robinson George A, Pineda-Torra Ines, Jury Elizabeth C
Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, London, United Kingdom.
Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom.
Front Med (Lausanne). 2022 Feb 14;9:814905. doi: 10.3389/fmed.2022.814905. eCollection 2022.
Cardio-vascular risk (CVR) stratification tools have been implemented in clinical practice to guide management decision for primary prevention of cardiovascular disease. Less is known about how we can optimally estimate the CVR in children and adolescents or about the reliability of the risk stratification tools validated in adult populations. Chronic inflammation associated with autoimmune rheumatic disease (ARD) drives an increased risk for accelerated atherosclerosis in patients of all ages. Although the research is less advanced than in adult populations, it is recognized that young people with ARDs with childhood-onset have increased CVR compared to age-matched healthy controls, as supported by studies investigating lipid biomarker profile and markers of endothelial dysfunction. Further research is needed to address the unmet need for adequate CVR identification and management strategies in young people in general, and in those with underlying chronic inflammation in particular. This perspective paper explores various challenges in adequately identifying and managing CVR in younger populations and potential directions for future research.
心血管风险（CVR）分层工具已应用于临床实践，以指导心血管疾病一级预防的管理决策。对于如何在儿童和青少年中最佳估计CVR，或在成年人群中验证的风险分层工具的可靠性，我们了解得较少。与自身免疫性风湿病（ARD）相关的慢性炎症会增加各年龄段患者加速动脉粥样硬化的风险。尽管该研究不如在成年人群中那样先进，但人们认识到，与年龄匹配的健康对照相比，患有儿童期发病的ARD的年轻人CVR增加，这得到了调查脂质生物标志物谱和内皮功能障碍标志物的研究的支持。总体而言，尤其是对于那些有潜在慢性炎症的年轻人，需要进一步研究以满足对充分识别和管理CVR的未满足需求。这篇观点文章探讨了在年轻人群中充分识别和管理CVR的各种挑战以及未来研究的潜在方向。
