Is Achieving the American Heart Association's Life Simple 7 Goals Sufficient to Reduce the Burden of Atrial Fibrillation? No Simple Answers.
Is Achieving the American Heart Association's Life Simple 7 Goals Sufficient to Reduce the Burden of Atrial Fibrillation? No Simple Answers.
复制标题
实现美国心脏协会的“Life Simple 7”目标足以减轻心房颤动的负担吗？
DOI：
10.1161/jaha.118.009127
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发表时间：
2018
影响因子：
5.4
通讯作者：
Darbar,Dawood
中科院分区：
文献类型：
--
作者：
McCabe,PamelaJ;Darbar,Dawood
血液研究所召集了一个小组，为预防心房颤动（AF）提供建议。在这份具有里程碑意义的报告中，该小组将调查参与健康行为对房颤预防的作用列为研究重点。20多年前，弗雷明汉心脏研究将年龄、高血压、充血性心力衰竭、冠状动脉疾病、瓣膜性心脏病和2型糖尿病确定为房颤发展的独立危险因素。2在过去的十年中，我们对可改变的危险因素（如肥胖、阻塞性睡眠呼吸暂停（OSA）、代谢综合征和过量饮酒）的作用的理解取得了稳步进展。新出现的证据强烈支持通过靶向可改变的危险因素来减轻房颤负担的概念，其中许多因素包括在美国心脏协会的LifeLs Simple 7 （LS7）中（即吸烟、体重指数、体力活动、饮食、总胆固醇、血压和空腹血糖）。这种方法可能会极大地遏制房颤流行的趋势。尽管最近在房颤导管治疗方面取得了进展，但对抗心律失常和消融治疗的反应是高度可变的。尽管抗心律失常药物仍然是对症房颤患者的一线治疗，但50%的房颤患者在6个月内复发，而且膜活性药物具有严重的毒性。5有限的
Blood Institute convened a panel to provide recommendations for the prevention of atrial fibrillation (AF). 1 In this landmark report, the panel listed investigating the role that engaging in healthy behaviors could have on AF prevention as a research priority. More than 2 decades ago, the Framingham Heart Study established age, hypertension, congestive heart failure, coronary artery disease, valvular heart disease, and type 2 diabetes mellitus as independent risk factors for the development of AF. 2 The past decade has witnessed steady progress in our understanding of the role of modifiable risk factors, such as obesity, obstructive sleep apnea (OSA), metabolic syndrome, and excess alcohol intake, in the pathogenesis of AF. 3 Emerging evidence strongly supports the concept of reducing the burden of AF by targeting modifiable risk factors, many of which are included in the American Heart AssociationLs LifeLs Simple 7 (LS7)(ie, smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting blood glucose). 4 Such an approach may dramatically stem the increasing tide of the AF epidemic.Despite recent advances in catheter-based therapy for AF, response to antiarrhythmic and ablation therapy is highly variable. Although antiarrhythmic drugs remain first-line therapy for patients with symptomatic AF, 50% experience a recurrence of AF within 6 months and membrane active drugs are associated with serious toxicities. 5 The limited