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目前预防心房颤动的证据:可改变的危险因素和危险因素干预的效果。

Current Evidence on Prevention of Atrial Fibrillation: Modifiable Risk Factors and the Effects of Risk Factor Intervention.

机构信息

From the Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey.

Department of Cardiology, Kirikkale Yuksek Ihtisas Hospital, Kirikkale, Turkey.

出版信息

Cardiol Rev. 2023;31(2):70-79. doi: 10.1097/CRD.0000000000000426. Epub 2021 Oct 20.

Abstract

Atrial fibrillation (AF) is one of the most encountered arrhythmias in clinical practice. It is also estimated that the absolute AF burden may increase by greater than 60% by 2050. It is inevitable that AF will become one of the largest epidemics in the world and may pose a major health problem for countries. Although AF rarely causes mortality in the acute period, it causes a significant increase in mortality and morbidity, including a fivefold increase in the risk of stroke, a twofold increase in dementia, and a twofold increase in myocardial infarction in the chronic period. Despite all the advances in the treatment of AF, it is better understood day by day that preventing AF may play a key role in reducing AF and its related complications. Modification of the main modifiable factors such as quitting smoking, abstaining from alcohol, changing eating habits, and exercise seems to be the first step in preventing AF. The strict adherence to the treatment process of secondary causes predisposing to AF such as DM, hypertension, obesity, and sleep apnea is another step in the prevention of AF. Both an individual approach and global public health campaigns can be highly beneficial to reduce the risk of AF. In this review, we aimed to summarize the current evidence on the relationship between modifiable risk factors and AF, and the impact of possible interventions on these factors in preventing or reducing the AF burden in the light of recently published guidelines and studies.

摘要

心房颤动(AF)是临床实践中最常见的心律失常之一。据估计,到 2050 年,AF 的绝对负担可能会增加超过 60%。AF 不可避免地将成为世界上最大的流行病之一,并可能给各国带来重大健康问题。尽管 AF 在急性期很少导致死亡率,但它会导致死亡率和发病率显著增加,包括中风风险增加五倍、痴呆风险增加两倍和心肌梗死风险增加两倍。尽管 AF 的治疗取得了所有进展,但人们越来越清楚的是,预防 AF 可能在减少 AF 及其相关并发症方面发挥关键作用。改变可改变的主要因素,如戒烟、戒酒、改变饮食习惯和锻炼,似乎是预防 AF 的第一步。严格遵守 DM、高血压、肥胖和睡眠呼吸暂停等导致 AF 的继发原因的治疗过程是预防 AF 的另一个步骤。个体方法和全球公共卫生运动都非常有助于降低 AF 的风险。在这篇综述中,我们旨在总结可改变的危险因素与 AF 之间的现有证据,以及根据最近发表的指南和研究,这些因素对预防或减轻 AF 负担的可能干预措施的影响。

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