The case for targeted mid-life interventions to prevent cardiovascular disease.
The case for targeted mid-life interventions to prevent cardiovascular disease.
复制标题
有针对性的中年干预措施预防心血管疾病的案例。
DOI：
10.1080/00015385.2019.1665850
复制
发表时间：
2020
影响因子：
1.6
通讯作者：
Celano,ChristopherM
中科院分区：
文献类型：
--
作者：
Huffman,JeffC;Massey,ChristinaN;Chung,Wei-Jean;Feig,EmilyH;Ibrahim,NasrienE;Celano,ChristopherM
Mid-life (the life stage spanning ages 45 to 64) is a critical period for cardiovascular health and are a rapidly growing age group across the US and Western Europe [1, 2]. During mid-life, the onset of cardiac-risk conditions, including hypertension [3] and type 2 diabetes [4], is very common and likely contributes to subsequent emergence of major cardiac events such as myocardial infarction (mean age of onset in Americans between 65–72)[5] in the years immediately following mid-life. A substantial contributor to the development cardiac disease in mid-life is poor adherence to health behaviours. Most mid-life adults do not meet recommended levels of physical activity [6], despite evidence that physical activity in mid-life is linked to lower rates of cardiac illness and greater survival over the following decade [7, 8]. Likewise, many mid-life persons have an unhealthy diet [9], smoke [10], or engage in binge drinking [11], all of which are also linked to heart disease. Why is mid-life adherence to cardiac health behaviours poor? Multiple competing demands in mid-life can conspire to impede cardiac health behaviour participation [12]. Many mid-life persons are at the pinnacle of their career, leading to more occupational demands and responsibilities [13]. Furthermore, they often have greater financial pressures related to mortgages, child care, tuition, and medical expenses [14], and in many cases they must provide care to children, adolescents, aging parents, or other family [15]. Indeed, in qualitative interviews in cardiac-related populations, mid-life persons report rates of occupational, financial, and caregiving stressors that were vastly higher than in other adults with the same conditions, and these stressors led to substantial time pressure [16]. These convergent factors may also contribute to greater psychological distress observed in mid-life persons at cardiac risk compared to older adults [16], and to the observation in the US, Europe, Asia, and Latin America that there is a U-shaped curve of psychological well-being that reaches its nadir during mid-life [17]. Such a combination of stress, time pressure, and low overall well-being can serve as a major barrier for mid-life adults to maintain healthy lifestyles [18].
