Cardiovascular risk assessment and cholesterol management in adolescents: getting to the heart of the matter.
Cardiovascular risk assessment and cholesterol management in adolescents: getting to the heart of the matter.
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DOI：
10.1097/mop.0b013e32833a6e22
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发表时间：
2010-08
影响因子：
3.6
通讯作者：
de Ferranti SD
中科院分区：
文献类型：
--
作者：
Gooding HC;de Ferranti SD
青春期是确定心血管疾病危险因素的常见时间，包括胆固醇升高。高胆固醇血症的检测和治疗指南对儿童和成人不同。本综述强调了这些差异，并讨论了青少年人群胆固醇管理的特殊考虑。一些纵向研究已经证实，青春期存在的心血管危险因素的数量，包括胆固醇升高，导致成人动脉粥样硬化。人们越来越认识到，其他慢性疾病，包括糖尿病、先天性心脏病、炎症性疾病和儿童癌症，也会加速这一过程。有一项举措是筛查和治疗更多胆固醇升高的年轻患者，以预防未来的心血管疾病。新的动脉粥样硬化标志物被用于量化研究人群中青少年的心血管疾病风险。包括药物治疗在内的几种干预措施的安全性和有效性日益得到确认。全面的心血管风险评估对青少年健康很重要，包括评估家族史和烟草使用沿着身体质量指数和血压的测量。此外，建议超重青少年或家族史未知的青少年以及20岁以下的所有患者进行胆固醇筛查。照顾青少年的提供者应该熟悉儿科和成人胆固醇筛查和治疗指南，以及常见的青少年疾病如何影响胆固醇水平。
Adolescence is a common time for the identification of cardiovascular disease risk factors, including elevated cholesterol. Guidelines for the detection and treatment of hypercholesterolemia differ for children and adults. This review highlights these differences and discusses special considerations for cholesterol management in the adolescent population. Several longitudinal studies have confirmed that the number of cardiovascular risk factors present in adolescence, including elevated cholesterol, lead to atherosclerosis in adults. There is increased awareness that other chronic medical conditions, including diabetes, congenital heart disease, inflammatory diseases, and childhood cancer, can accelerate this process. There is a move to screen and treat more young patients with elevated cholesterol to prevent future cardiovascular disease. New markers of atherosclerosis are being used to quantify cardiovascular disease risk in adolescents in research populations. The safety and efficacy of several interventions, including drug therapy, is increasingly established. Comprehensive cardiovascular risk assessment is important for adolescent health and includes assessment of family history and tobacco use along with measurement of body mass index and blood pressure. Additionally, cholesterol screening is recommended for overweight adolescents or those with an unknown family history and for all patients by the age of 20. Providers caring for adolescents should be familiar with both the pediatric and adult cholesterol screening and treatment guidelines as well as how common adolescent conditions affect cholesterol levels.