Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
Can J Cardiol. 2023 Sep;39(9):1229-1243. doi: 10.1016/j.cjca.2023.07.002. Epub 2023 Jul 6.
Hypertension is the primary cause of cardiovascular diseases and is responsible for nearly 9 million deaths worldwide annually. Increasing evidence indicates that in addition to pathophysiologic processes, numerous environmental factors, such as geographic location, lifestyle choices, socioeconomic status, and cultural practices, influence the risk, progression, and severity of hypertension, even in the absence of genetic risk factors. In this review, we discuss the impact of some environmental determinants on hypertension. We focus on clinical data from large population studies and discuss some potential molecular and cellular mechanisms. We highlight how these environmental determinants are interconnected, as small changes in one factor might affect others, and further affect cardiovascular health. In addition, we discuss the crucial impact of socioeconomic factors and how these determinants influence diverse communities with economic disparities. Finally, we address opportunities and challenges for new research to address gaps in knowledge on understanding molecular mechanisms whereby environmental factors influence development of hypertension and associated cardiovascular disease.
高血压是心血管疾病的主要病因，每年在全球导致近 900 万人死亡。越来越多的证据表明，除了病理生理过程外，许多环境因素，如地理位置、生活方式选择、社会经济地位和文化习俗，都会影响高血压的风险、进展和严重程度，即使在没有遗传风险因素的情况下也是如此。在这篇综述中，我们讨论了一些环境决定因素对高血压的影响。我们重点讨论了来自大型人群研究的临床数据，并讨论了一些潜在的分子和细胞机制。我们强调了这些环境决定因素是如何相互关联的，因为一个因素的微小变化可能会影响其他因素，并进一步影响心血管健康。此外，我们还讨论了社会经济因素的关键影响，以及这些决定因素如何影响经济差异较大的不同社区。最后，我们探讨了新研究的机会和挑战，以解决在理解环境因素影响高血压和相关心血管疾病发展的分子机制方面存在的知识差距。
