Cardiovascular disease and modifiable cardiometabolic risk factors.
Cardiovascular disease and modifiable cardiometabolic risk factors.
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DOI：
10.1016/s1098-3597(07)80025-1
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Cannon, Christopher P
中科院分区：
文献类型：
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作者：
Cannon, Christopher P
心血管疾病（CVD）是美国和世界许多地区的主要死亡原因。心血管疾病的潜在可改变的危险因素包括吸烟、缺乏体力活动、高血压、低密度脂蛋白胆固醇升高和一系列相互关联的代谢危险因素。在过去的几十年里，预防或治疗CVD危险因素的努力已经导致CVD相关死亡率显着降低。然而，许多患者从未达到足够的控制心血管疾病的危险因素，即使这些因素已经确定。此外，肥胖症和2型糖尿病（DM）的患病率不断增加，可能会破坏CVD已取得的改善。在美国，大约三分之二的成年人超重或肥胖，即使是轻微的超重也会导致心血管疾病相关死亡风险显着增加。促进体重减轻的生活方式干预可以降低心血管疾病相关疾病的风险，但患者难以长期维持。肥胖发生率的增加也导致其他重要CVD风险因素的患病率显著增加，包括高血压、血脂异常、胰岛素抵抗和2型糖尿病。目前有药物治疗可用于解决个体CVD风险因素，其他药物正在评估中，包括内源性大麻素受体拮抗剂，过氧化物酶体增殖物激活受体亚型α和γ的抑制剂，以及几种调节胰高血糖素样肽-1活性的药物。新药物有可能通过单一药物显着改善几种CVD风险因素，并可能为临床医生提供几种新的策略来降低CVD的长期风险。
Cardiovascular disease (CVD) is the leading cause of death in the United States and many parts of the world. Potentially modifiable risk factors for CVD include tobacco use, physical inactivity, hypertension, elevated low-density lipoprotein cholesterol, and a cluster of interrelated metabolic risk factors. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients never achieve adequate control of CVD risk factors even when these factors have been identified. In addition, the growing prevalence of obesity and type 2 diabetes mellitus (DM) threatens to undermine the improvements in CVD that have been achieved. In the United States, approximately two thirds of adults are overweight or obese, and even modest excess body weight is associated with a significantly increased risk of CVD-related mortality. Lifestyle interventions to promote weight loss reduce the risk of CVD-related illness but are difficult for patients to sustain over long periods of time. The increased incidence of obesity has also contributed to significant increases in the prevalence of other important CVD risk factors, including hypertension, dyslipidemia, insulin resistance, and type 2 DM. Pharmacologic therapies are currently available to address individual CVD risk factors, and others are being evaluated, including endocannabinoid receptor antagonists, inhibitors of peroxisome proliferator-activated receptor subtypes alpha and gamma, and several agents that modulate the activity of glucagon-like peptide-1. The new agents have the potential to significantly improve several CVD risk factors with a single medication and may provide clinicians with several new strategies to reduce the long-term risk of CVD.