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动脉粥样硬化危险因素管理 - 神经科医生的新挑战?

Atherosclerosis risk factor management - what's new for the neurologist?

机构信息

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto do Coração, São Paulo SP, Brazil.

出版信息

Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):88-93. doi: 10.1590/0004-282X-ANP-2022-S102.

DOI:10.1590/0004-282X-ANP-2022-S102
PMID:35976292
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9491406/
Abstract

Stroke is the second leading cause of death worldwide and the vast majority can be attributed to modifiable risk factors, mainly behavioral and metabolic. The top six risk factors responsible for cardiovascular mortality in Brazil in 2019 were high systolic blood pressure, inadequate dietary exposure, high body mass index, high LDL cholesterol, high fasting blood glucose levels, and tobacco. We intend to discuss in this paper the evidence and recommendations in the approach of three essential risk factors for patients with a history of stroke: dyslipidemia, hypertension and diabetes.

摘要

中风是全球范围内的第二大致死原因,而绝大多数中风都可以归因于可改变的风险因素,主要是行为和代谢因素。2019 年导致巴西心血管疾病死亡的前六大风险因素为:收缩压高、膳食摄入不足、体重指数高、低密度脂蛋白胆固醇高、空腹血糖水平高和吸烟。本文旨在讨论有中风病史的患者的三个重要风险因素(血脂异常、高血压和糖尿病)的处理方法中的证据和建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b638/9491406/ad62d6b53638/1678-4227-anp-80-05-s1-s102-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b638/9491406/ad62d6b53638/1678-4227-anp-80-05-s1-s102-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b638/9491406/ad62d6b53638/1678-4227-anp-80-05-s1-s102-gf1.jpg

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本文引用的文献

1
Association Between Intensity of Low-Density Lipoprotein Cholesterol Reduction With Statin-Based Therapies and Secondary Stroke Prevention: A Meta-analysis of Randomized Clinical Trials.他汀类药物降低低密度脂蛋白胆固醇强度与二级卒中预防的关系:一项随机临床试验的荟萃分析。
JAMA Neurol. 2022 Apr 1;79(4):349-358. doi: 10.1001/jamaneurol.2021.5578.
2
Burden of Cardiovascular diseases attributable to risk factors in Brazil: data from the "Global Burden of Disease 2019" study.巴西心血管疾病负担与风险因素的关系:来自“全球疾病负担 2019”研究的数据。
Rev Soc Bras Med Trop. 2022 Jan 28;55(suppl 1):e0263. doi: 10.1590/0037-8682-0263-2021. eCollection 2022.
3
Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension.
老年高血压患者强化血压控制试验。
N Engl J Med. 2021 Sep 30;385(14):1268-1279. doi: 10.1056/NEJMoa2111437. Epub 2021 Aug 30.
4
Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.1990—2019年全球、区域和国家的卒中负担及其风险因素:全球疾病负担研究2019的系统分析
Lancet Neurol. 2021 Oct;20(10):795-820. doi: 10.1016/S1474-4422(21)00252-0. Epub 2021 Sep 3.
5
Lipoprotein (a) level as a risk factor for stroke and its subtype: A systematic review and meta-analysis.脂蛋白(a)水平作为中风及其亚型的危险因素:系统评价和荟萃分析。
Sci Rep. 2021 Aug 2;11(1):15660. doi: 10.1038/s41598-021-95141-0.
6
Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol.脂蛋白(a)与 LDL 胆固醇控制良好患者接受 PCSK9 抑制剂治疗的获益。
J Am Coll Cardiol. 2021 Aug 3;78(5):421-433. doi: 10.1016/j.jacc.2021.04.102.
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Effects of SGLT2 inhibitors on stroke and its subtypes in patients with type 2 diabetes: a systematic review and meta-analysis.钠-葡萄糖协同转运蛋白2抑制剂对2型糖尿病患者中风及其亚型的影响:一项系统评价和荟萃分析。
Sci Rep. 2021 Jul 28;11(1):15364. doi: 10.1038/s41598-021-94945-4.
8
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Stroke. 2021 Jul;52(7):e364-e467. doi: 10.1161/STR.0000000000000375. Epub 2021 May 24.
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Stroke. 2020 May;51(5):1546-1554. doi: 10.1161/STROKEAHA.119.027759. Epub 2020 Apr 21.
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GLP-1 receptor agonists in diabetes for stroke prevention: a systematic review and meta-analysis.GLP-1 受体激动剂在糖尿病中的应用与卒中预防:一项系统评价和荟萃分析。
J Neurol. 2020 Jul;267(7):2117-2122. doi: 10.1007/s00415-020-09813-4. Epub 2020 Apr 4.