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Ann Intern Med:年轻人患动脉粥样硬化性心血管疾病风险升高了?

2017-05-17 MedSci MedSci原创

美国心脏病学会和美国心脏病学会(ACC / AHA)发布的2013年胆固醇管理指南建议:在所有20岁以上的成年人中进行脂质筛查,来筛查出动脉粥样硬化性心脏病(ASCVD)的高风险人群。对于10年间风险升高(> 5%)或低密度脂蛋白胆固醇(LDL-C)水平高于4.92 mmol / L(190 mg / dL)或更高的患者,可考虑使用他汀类药物。

美国心脏病学会和美国心脏病学会(ACC / AHA)发布的2013年胆固醇管理指南建议:在所有20岁以上的成年人中进行脂质筛查,目的是筛查出动脉粥样硬化性心脏病(ASCVD)的高风险人群。对于10年间患病风险升高(> 5%)或低密度脂蛋白胆固醇(LDL-C)水平高于4.92 mmol / L(190 mg / dL)的患者,可考虑使用他汀类药物进行治疗。

为了探究年龄在50岁以下的非糖尿病患者ASCVD风险升高的患病率。研究人员进行了一项从1999年-2000年至2011年-2012年的国家健康与营养调查研究,近日该研究发表在权威医学期刊内科学年鉴(Annals of Internal Medicine),下面简要介绍一下该项研究的内容。

研究人员选取30岁至49岁并且没有ASCVD或糖尿病的成年人。使用2013年ACC/AHA推荐的ASCVD风险计算器来估计10年间的ASCVD风险。研究人员将参与者按年龄,性别,吸烟史和高血压等进行细分。

该研究总共对9608名参与者进行了调查,通过该数据来反映整体6790万成年人的总体情况,其中大约一半(47.12%,占3200万成年人)为低流行亚组。在没有吸烟或高血压的情况下,0.09%的40岁以下成年男性(95%CI,0.02%至0.35%)和0.04%的50岁以下成年女性(CI,0.0%至0.26%)有ASCVD风险升高的倾向。其他亚组中,分别有0%至75.9%的不等比例参与者的患病风险增加。总体而言,2.9%参与者(CI,2.3%-3.5%)的LDL-C水平大于等于4.92mmol / L(190mg / dL)。

最终,研究人员指出:在没有危险因素的情况下,年龄在50岁以下的男性和40岁以下的男性中ASCVD风险增加的发生率较低。

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