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EHJ盘点:2020年心血管疾病进展——冠心病预防

2021-02-09 Nebula MedSci原创

一起来看看心血管疾病领域大牛们的冠心病预防建议吧~

近日,European Heart Journal(EHJ)发表了一系列文章盘点心血管医学2020年度新进展,让我们一起来看看冠心病预防方面都有哪些总结吧~

Ramon Estruch教授

  • 西班牙巴塞罗纳生物医学研究所营养、血管风险因素和衰老研究组的带头人
  • 地中海型饮食基金的科技总监
  • 巴塞罗那大学副教授
  • PREDIMED试验的协调人和PI
  • 在同行评审期刊上发表了540多份稿件

Ramon Estruch教授是心血管预防领域的领头人。研究内容涵盖地中海型饮食对于心血管的作用;初榨橄榄油对心血管风险因素和与动脉粥样硬化相关的氧化应激和炎性生物标志物的作用;适量饮用红酒和啤酒的作用:对与动脉粥样硬化发展相关的细胞和内皮黏附分子的表达和功能的影响;长期酒精摄入对心脏、肝和脑的影响。

Estruch教授表示,“我们有很好的对付心血管疾病的武器,但在癌症预防和治疗方面,我们还有很多需要学习。此外,心血管疾病和癌症有很多共同之处,因此,我们从心血管疾病预防中学到的经验或许在癌症研究中也很用”。

PREDIMED试验评估了地中海型饮食与心血管疾病风险的相关性,Estruch教授认为“REDIMED试验最大的成就是用最高水平的证据证实传统地中海型饮食将心血管事件风险降低了30%,该效果堪比服用药物(如他汀类),且无副作用”。

对于心血管疾病预防,“女性心血管疾病的发生率高于男性,因而女性和男性应采取不同的治疗策略;新的遗传学进展使高胆固醇血症患者的精准治疗取得进展;青少年时期的体育活动可以降低心血管疾病的长期风险;间歇性禁食可以减轻体重,改善几种慢性疾病,并“逆转”衰老;而健康的睡眠模式可以减少34%的冠心病和卒中”。

此外,“代谢组学分析使我们能够更好地根据饮食反应和疾病风险对个体进行分层,新的证据表明蔬菜和膳食纤维的摄入对缺血性卒中具有保护作用,而大量摄入蛋制品可增加出血性卒中风险”。“钠葡萄糖共转运体2抑制剂已被证明对CVD和肾脏预后都有良好的作用,包括延缓糖尿病肾病进展”。Circulation:达格列净可明显改善慢性肾病患者的多种不良预后结局!

展望2021年,Estruch教授相信“在越来越强大的基因检测的帮助下,精准医疗将会获得更好的发展”。Estruch教授还表示,其将会开展一项关于心血管、神经系统和癌症的联合研究项目。他还希望,COVID-19之后,基金能够继续支持CVD和癌症相关研究。Circulation:一种新遗传风险评分可预测心血管代谢疾病患者的卒中风险

“我衷心的希望,在新的一年中,我们可以有对抗COVID-19的安全有效的疫苗,这样COVID-19就不会扭转过去这几年我们在心血管预防上取得的进展”,Estruch教授。

 

Luis Miguel Ruilope博士

  • 马德里12de Octubre医院研究所 心肾研究主任
  • 西班牙流动血压监测协会(ABPM)主席
  • 致力于高血压和心血管风险领域研究
  • 重点关注与控制动脉高压和共发病(特别是糖尿病、高脂血症和慢性肾病[CKD])相关的心血管预防

以估算肾小球滤过率=60 mL/min/m2 界定有无CKD就是由Ruilope博士提出的,一经提出,就得到了肾脏指南KDIGO认可,一直沿用至现在。

“肥胖是一种常见的心血管疾病伴发病,可考虑采用药物或手术治疗。生活方式-饮食和体育活动-仍然是充分预防CV疾病的基础。”Circulation:2型糖尿病:降低体脂、减小腰围=降低心衰风险!

Ruilope博士认为,心血管疾病预防的重点:在考虑难治性高血压的合理治疗前,应先明确难治性高血压的定义;需要在年轻时候(40岁以下)就开始对心肾风险进行适当干预。

此外,Ruilope博士还认为,心肾风险相关领域研究是一项持续发展的研究,将持续到2021年,同时还可定义早期心肾风险(在出现蛋白尿、eGFR低于60和发展出CV疾病之前)表型。

 

Francesco Cosentino教授

  • 卡罗林斯卡医学院心脏病学教授
  • ESC的副主席
  • 欧洲心脏杂志的责任编辑
  • 心血管研究的咨询编辑
  • 主持了2019年编制糖尿病、糖尿病前期及心血管疾病的ESC指南的筹备任务
  • 致力于研究在心血管代谢风险升高的情况下,基因环境相互作用对心血管表型的影响

Cosentino教授,“虽然医疗技术的进步降低了发病率和死亡率,但心血管疾病的危险远未根除,基于机制的治疗方法仍有很高的需求。从这个角度来看,破译心血管疾病的分子网络将有助于开发新的治疗策略”。

Cosentino教授的研究项目还旨在了解环境因素、代谢性疾病和心血管过早衰老之间的联系。近年来是糖尿病和CVD领域最兴奋的时期之一,多个心血管预后试验(CVOTs)试用了多种新型降糖药。

“ESC指南反映了前所未有的新证据基础的增加,并推动了对高/非常高CV风险的糖尿病患者的管理范式的转变。由于已有药物显示出显著的心血管和肾脏保护作用,我们正从以血糖为中心的观点转向事件驱动的方法。”Circulation:糖尿病会影响恩格列净对心衰患者的效益吗?

原始出处:

Mark Nicholls, The Year in Cardiovascular Medicine 2020: Coronary Prevention: Looking back on the Year in Cardiovascular Medicine for 2020 in the field of coronary prevention is Professor Ramon Estruch, Dr Luis Ruilope, and Professor Francesco Cosentino. Mark Nicholls meets them, European Heart Journal, 2021;, ehaa1023, https://doi.org/10.1093/eurheartj/ehaa1023

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    2021-10-19 qingbao2004

    优秀

    0

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    2021-03-03 carrotlyl

    嗯嗯

    0

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