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Long-Term Effects of Childhood Risk Factors on Cardiovascular Health During Adulthood. 儿童期危险因素对成年期心血管健康的长期影响
Pub Date : 2015-08-12 DOI: 10.4137/CMRVH.S29964
Roman Shrestha, Michael Copenhaver

The primary purpose of this article is to provide a broad overview of the research on the long-term effects of childhood risk factors on cardiovascular diseases (CVDs) during adulthood and to outline recommendations for prevention of CVDs based on evidence-based interventions (EBIs). CVDs are the leading cause of death and a major cause of disability in the United States and globally. Risk factors for CVDs are already identifiable in children and youth, and include both modifiable factors (e.g., unhealthy diet, physical inactivity, tobacco smoking), and factors that cannot be changed (e.g., age, heredity, sex). A fundamental issue has been the severity of the long-term effects of childhood risk factors (i.e., behavioral and intermediate risk factors) on subsequent cardiovascular health. It is clear from the empirical evidence that risk factors for CVDs can develop during childhood and adolescence. These risk factors in childhood have been linked to adverse health outcomes, including CVDs, during adulthood. The findings thus far suggest that, in order to be effective and reduce the risk of adulthood CVDs, intervention strategies should begin during childhood. The findings also underscore the importance of adopting a healthy lifestyle as early in life as possible.

本文的主要目的是对儿童期危险因素对成年期心血管疾病(cvd)的长期影响的研究进行综述,并概述基于循证干预(EBIs)的心血管疾病预防建议。心血管疾病是美国和全球范围内导致死亡和残疾的主要原因。在儿童和青少年中,心血管疾病的危险因素已经可以确定,包括可改变的因素(例如,不健康的饮食、缺乏身体活动、吸烟)和不能改变的因素(例如,年龄、遗传、性别)。一个根本问题是儿童期风险因素(即行为和中间风险因素)对随后的心血管健康的长期影响的严重性。从经验证据可以清楚地看出,心血管疾病的危险因素可能在儿童期和青春期形成。儿童期的这些风险因素与成年期的不良健康结果(包括心血管疾病)有关。迄今为止的研究结果表明,为了有效降低成年期心血管疾病的风险,干预策略应该从儿童时期开始。研究结果还强调了尽可能早地养成健康生活方式的重要性。
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引用次数: 48
High-Risk Patients with Hypertension: Clinical Management Options. 高血压高危患者:临床管理选择。
Pub Date : 2013-10-08 DOI: 10.4137/CMRVH.S8109
Candace D McNaughton, Wesley H Self, Phillip D Levy, Tyler W Barrett

Hypertension, one of the most common human diseases worldwide, affects nearly 1 billion individuals. Complaints related to hypertension are commonly evaluated and treated in the acute care settings such as emergency departments and acute care medical clinics. The evaluation, treatment, and disposition of these patients require thorough knowledge of potential complications and treatment options. This manuscript details a structured approach to evaluating high-risk patients with acute hypertension-related complaints and provides recommendations for treatment and disposition.

高血压是世界上最常见的人类疾病之一,影响着近10亿人。与高血压有关的投诉通常在急诊科和急症医疗诊所等急症护理机构进行评估和治疗。这些患者的评估、治疗和处置需要对潜在的并发症和治疗方案有全面的了解。本文详细介绍了一种结构化的方法来评估高风险患者与急性高血压相关的投诉,并提供了治疗和处置的建议。
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引用次数: 5
LOWERING THE RISK FOR THROMBUS AND STROKE IN ATRIAL FIBRILLATION PATIENTS: Will Dabigatran Replace Warfarin? 降低心房颤动患者血栓形成和中风的风险:达比加群能否取代华法林?
Pub Date : 2013-06-20 DOI: 10.4137/CMRVH.S6415
Alex Y Tan, Michael A Rosenberg

The use of oral anticoagulation to reduce stroke risk from thromboembolism has become the cornerstone of management of atrial fibrillation. Dabigatran is a direct thrombin inhibitor, which in contrast to warfarin, does not require regular blood draws for monitoring effect. Randomized controlled studies suggest that dabigatran may be more effective than warfarin at higher doses without an increased bleeding risk, and equally effective at lower doses, with lower bleeding risk. With these apparent advantages comes a higher cost, and limited use in patients with underlying renal or liver disease. In addition, the inability to measure anticoagulant effect, as with warfarin, presents a double-edged sword for clinical use of dabigatran. In this review, we discuss the mechanisms of action, clinical effect, and place in therapy of dabigatran as a possible replacement for warfarin.

使用口服抗凝药降低血栓栓塞引起中风的风险已成为心房颤动治疗的基石。达比加群是一种直接凝血酶抑制剂,与华法林相比,它不需要定期抽血监测效果。随机对照研究表明,达比加群在高剂量下可能比华法林更有效,但不会增加出血风险,在低剂量下同样有效,但出血风险较低。这些明显的优势带来的是较高的成本,以及在有潜在肾病或肝病患者中的有限使用。此外,与华法林一样,达比加群也无法测量抗凝效果,这对达比加群的临床应用来说是一把双刃剑。在这篇综述中,我们将讨论达比加群的作用机制、临床效果以及作为华法林可能替代品的治疗地位。
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引用次数: 0
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Clinical medicine reviews in vascular health
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