家族史在青年心血管健康管理中的作用在临床实践中是否仍然相关?
Is Family History for the Management of Cardiovascular Health in Youth Still Relevant in Clinical Practice?
机构信息
Preventive Cardiology Program, Cardiac Center, Nemours Children's Health, 2202 State Ave STE 102, Panama City, FL, 32405, USA.
College of Medicine, University of Central Florida, 6535 Nemours Parkway, Orlando, FL, 32827, USA.
出版信息
Curr Atheroscler Rep. 2024 Nov;26(11):629-637. doi: 10.1007/s11883-024-01232-4. Epub 2024 Aug 27.
PURPOSE OF REVIEW
Family history of premature cardiovascular disease is a strong predictor of individual cardiovascular risk. However, family history is not always available and not always reliable. Roughly 80% of health outcomes are influenced not by genetic risk but by societal factors, including adverse health behaviors and environment. Furthermore, in the present age of genetic testing, laboratory evaluations, and imaging, a key question remains: What is the contemporary relevance of family history screening in the management of cardiovascular disease in youth?
RECENT FINDINGS
Knowledge of an individual's family history can help clinicians identify not only inherited risk but also familial clustering of unhealthy behaviors and environmental adversity contributing to enhanced cardiovascular disease risk in youth. For those at greatest risk, prevention strategies can be applied sooner and more conservatively. Integrating family history into clinical practice is crucial for cardiovascular risk assessment and for optimizing outcomes, but, in some cases, is more reflective of social factors.
目的综述
早发性心血管疾病的家族史是个体心血管风险的一个强有力的预测指标。然而,家族史并不总是可用的,也并不总是可靠的。大约 80%的健康结果不是由遗传风险而是由社会因素(包括不良的健康行为和环境)决定的。此外,在当今基因检测、实验室评估和影像学的时代,仍然存在一个关键问题:在青少年心血管疾病的管理中,家族史筛查的当代相关性如何?
最近的发现
了解个体的家族史不仅可以帮助临床医生识别遗传风险,还可以识别不健康行为和环境逆境的家族聚集,这些因素会增加青少年患心血管疾病的风险。对于那些风险最大的人,可以更早、更保守地应用预防策略。将家族史纳入临床实践对于心血管风险评估和优化结果至关重要,但在某些情况下,它更多地反映了社会因素。