Environmental Determinants of Cardiovascular Disease.
Environmental Determinants of Cardiovascular Disease.
复制标题
心血管疾病的环境决定因素。
DOI：
10.1161/circresaha.117.306458
复制
发表时间：
2017-07-07
影响因子：
20.1
通讯作者：
Bhatnagar A
中科院分区：
文献类型：
--
作者：
Bhatnagar A
环境的许多特征已被发现对心血管疾病（CVD）的风险、进展和严重程度产生重要影响。即使在没有遗传变化的情况下，迁移到不同地理位置所导致的环境变化、生活方式选择的改变以及社会政策和文化习俗的转变也会改变心血管疾病的风险。然而，环境对心血管疾病风险的累积影响一直难以评估，一些环境因素影响心血管疾病的机制仍然不清楚。人类环境是复杂的；由于人类生态系统、进化史、社会结构和个人选择的多样性，他们的自然、社会和个人领域是高度可变的。越来越多的证据支持这样一种观点，即生态特征，如昼夜循环、阳光照射、季节和自然环境的地理特征，如海拔、纬度和绿地，是心血管健康和心血管疾病风险的重要决定因素。在高度发达的社会中，自然环境的影响受到社会环境的物理特征（如建筑环境和污染）以及社会经济地位和社会网络的制约。社会环境的这些属性决定了生活方式的选择，从而显著改变心血管疾病的风险。了解环境的不同领域如何单独和集体地影响心血管疾病的风险，可以更好地评估心血管疾病，并有助于制定新的预防和治疗策略，以限制日益高的全球心脏病和中风负担。
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.