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肥胖的风险分层与治疗用于心血管疾病的一级和二级预防

Risk Stratification and Treatment of Obesity for Primary and Secondary Prevention of Cardiovascular Disease.

作者信息

Ostrominski John W, Powell-Wiley Tiffany M

机构信息

Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

出版信息

Curr Atheroscler Rep. 2024 Jan;26(1):11-23. doi: 10.1007/s11883-023-01182-3. Epub 2023 Dec 30.

Abstract

PURPOSE OF REVIEW

In this review, we discuss contemporary and emerging approaches for risk stratification and management of excess adiposity for the primary and secondary prevention of cardiovascular disease.

RECENT FINDINGS

Obesity is simultaneously a pandemic-scale disease and major risk factor for the incidence and progression of a wide range of cardiometabolic conditions, but risk stratification and treatment remain clinically challenging. However, sex-, race-, and ethnicity-sensitive anthropometric measures, body composition-focused imaging, and health burden-centric staging systems have emerged as important facilitators of holistic risk prediction. Further, expanding therapeutic approaches, including comprehensive lifestyle programs, anti-obesity pharmacotherapies, device/endoscopy-based interventions, metabolic surgery, and novel healthcare delivery resources offer new empowerment for cardiovascular risk reduction in individuals with obesity. Personalized risk stratification and weight management are central to reducing the lifetime prevalence and impact of cardiovascular disease. Further evidence informing long-term safety, efficacy, and cost-effectiveness of novel approaches targeting obesity are critically needed.

摘要

综述目的

在本综述中,我们讨论了用于肥胖症风险分层和管理的当代及新兴方法,以用于心血管疾病的一级和二级预防。

最新发现

肥胖既是一种大流行规模的疾病,也是多种心血管代谢疾病发生和进展的主要危险因素,但风险分层和治疗在临床上仍然具有挑战性。然而,对性别、种族和民族敏感的人体测量方法、以身体成分为重点的成像技术以及以健康负担为中心的分期系统已成为全面风险预测的重要推动因素。此外,不断扩展的治疗方法,包括综合生活方式计划、抗肥胖药物治疗、基于设备/内镜的干预措施、代谢手术以及新型医疗保健资源,为肥胖个体降低心血管风险提供了新的助力。个性化风险分层和体重管理对于降低心血管疾病的终生患病率和影响至关重要。迫切需要更多证据来证明针对肥胖症的新方法的长期安全性、有效性和成本效益。

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