风湿性疾病患者的心血管风险管理。

Managing Cardiovascular Risk in Patients with Rheumatic Disease.

机构信息

Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.

出版信息

Rheum Dis Clin North Am. 2022 May;48(2):429-444. doi: 10.1016/j.rdc.2022.02.003.

DOI:10.1016/j.rdc.2022.02.003

Abstract

Individuals with rheumatoid arthritis, systemic lupus erythematosus, or gout have increased risk of cardiovascular disease (CVD) compared with the general population. This risk relates to a combination of traditional cardiovascular risk factors and disease-specific factors. Screening for CVD is important because CVD contributes to significant morbidity and mortality. Management includes tight control of disease activity to reduce inflammation, but with care to minimize use of nonsteroidal anti-inflammatory drugs and prolonged courses of high-dose corticosteroids. Traditional cardiovascular risk factors should be managed with a combination of lifestyle interventions and pharmacotherapy. The decision to start antihypertensive and lipid-lowering therapy should be based on individual CVD risk.

摘要

与普通人群相比，类风湿关节炎、系统性红斑狼疮或痛风患者发生心血管疾病（CVD）的风险增加。这种风险与传统心血管危险因素和疾病特异性因素的综合作用有关。CVD 筛查很重要，因为它会导致严重的发病率和死亡率。治疗包括严格控制疾病活动以减少炎症，但要注意尽量减少使用非甾体抗炎药和长期大剂量皮质类固醇。应结合生活方式干预和药物治疗来控制传统心血管危险因素。开始降压和降脂治疗的决定应基于个体 CVD 风险。