Department of Medicine, Tinsley Harrison Internal Medicine Residency Program (Dr Morton), and Division of Cardiovascular Disease (Drs Heindl, Clarkson, and Bittner) The University of Alabama at Birmingham.
J Cardiopulm Rehabil Prev. 2022 Nov 1;42(6):389-396. doi: 10.1097/HCR.0000000000000748.
The primordial prevention of atherosclerotic cardiovascular disease (ASCVD) involves the prevention of the onset of its risk factors. This review explores the associations between early modifiable risk factors and the development of ASCVD in adulthood, as well as evidence-based interventions to prevent them.
A review was conducted on the basis of an in-depth literature search including longitudinal observational data, systematic reviews and meta-analyses published in 2012 or later, clinical trials, and additional manual searches of recent literature based on reference lists of other reviews and relevant guidelines.
ASCVD is a disease that begins in childhood; hence, primordial prevention is an important target for improving cardiovascular morbidity and mortality later in life. Data from large-scale population studies have consistently identified the following modifiable risk factors for the development of ASCVD: smoking, overweight and obesity, high cholesterol, high blood pressure, hyperglycemia, poor diet, and physical inactivity. These risk factors originate during the prenatal, childhood, and adolescent stages of life. Various successful interventions to prevent the onset of each risk factor have been evaluated at the individual, community, and population levels. Implementation of a heart-healthy dietary pattern and regular exercise early in life are large components of many successful interventions.
动脉粥样硬化性心血管疾病(ASCVD)的一级预防涉及预防其危险因素的发生。本综述探讨了早期可改变的危险因素与成年期 ASCVD 发展之间的关系,以及预防这些危险因素的循证干预措施。
根据 2012 年或之后发表的纵向观察性数据、系统评价和荟萃分析、临床试验,以及基于其他综述和相关指南的参考文献的最新文献的额外手动搜索,进行了综述。
ASCVD 是一种始于儿童期的疾病;因此,原始预防是改善成年后心血管发病率和死亡率的重要目标。来自大规模人群研究的数据一致确定了以下可改变的 ASCVD 发病风险因素:吸烟、超重和肥胖、高胆固醇、高血压、高血糖、不良饮食和身体活动不足。这些危险因素起源于生命的产前、儿童和青少年阶段。已经在个体、社区和人群层面评估了各种预防每种风险因素发生的成功干预措施。在生命早期实施健康的饮食模式和定期运动是许多成功干预措施的重要组成部分。