Allen J K, Blumenthal R S
Johns Hopkins University School of Nursing, Baltimore, Maryland 21205-2100, USA.
Am J Cardiol. 1995 Jun 1;75(16):1092-5. doi: 10.1016/s0002-9149(99)80736-x.
The coronary risk factor status of women before and after coronary artery bypass grafting has not been fully described. This study was a prospective investigation of 136 women who underwent first-time, isolated coronary artery bypass grafting between February 1992 and October 1993. Major coronary risk factors were measured at the time of surgery and again 6 months later. The sample was 22% black, had a mean age of 64 years, and an average of 11 years of education. Substantial favorable changes in risk factor status occurred in the prevalence of smoking and the number of cigarettes smoked per day among smokers. Although the self-reported dietary intake of fat decreased significantly, the dietary consumption of fat, saturated fat, and cholesterol remained above the recommended levels of the Step II diet and weights remained essentially the same. Mean systolic and diastolic blood pressures significantly increased and a substantial number of patients (59%) continued to exhibit hypertension at 6 months. No significant changes in plasma lipid concentrations were achieved. At 6 months, one third of the women exceeded recommended levels for triglycerides, 85% for total cholesterol, and 92% for low-density lipoproteins. In addition, 34% had high-density lipoprotein levels < 40 mg/dl. Health care professionals need to target these women for effective secondary prevention.
冠状动脉搭桥术前后女性的冠心病危险因素状况尚未得到充分描述。本研究对1992年2月至1993年10月期间首次接受单纯冠状动脉搭桥术的136名女性进行了前瞻性调查。在手术时和6个月后再次测量主要的冠心病危险因素。样本中22%为黑人，平均年龄64岁，平均受教育年限11年。吸烟者的吸烟率和每日吸烟量等危险因素状况出现了显著的有利变化。虽然自我报告的脂肪饮食摄入量显著下降，但脂肪、饱和脂肪和胆固醇的饮食消耗量仍高于第二步饮食推荐水平，体重基本保持不变。平均收缩压和舒张压显著升高，大量患者（59%）在6个月时仍患有高血压。血浆脂质浓度未出现显著变化。在6个月时，三分之一的女性甘油三酯水平超过推荐水平，85%的女性总胆固醇水平超过推荐水平，92%的女性低密度脂蛋白水平超过推荐水平。此外，34%的女性高密度脂蛋白水平<40mg/dl。医疗保健专业人员需要针对这些女性进行有效的二级预防。
