梅斯心血管疾病进展 (007期)

2021-07-09 K.K MedSci原创

编者按:梅斯医学将定期进行汇总,帮助大家概览心血管领域最新进展。下面是呈现给大家的最新一期的心血管进展。enjoy~

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上一期见:梅斯血管疾病进展(006期)

1. 2021 ESC科学饮食建议:素食应该在心脏健康饮食中占主导地位

近日,发表在Cardiovascular Research杂志的一项研究,全面分析和回顾了饮食与CVD之间关系的证据,以更新预防CVD的饮食策略。研究强调,素食应该在心脏健康饮食中占主导地位。

证据高度一致地表明,对健康的成年人来说,少吃盐和动物源性食物,增加素食的摄入量(包括全谷物、水果、蔬菜、豆类和坚果)与降低动脉硬化的风险有关。用橄榄油和其他富含不饱和脂肪的油取代黄油和其他动物脂肪也是如此。

食用动物源性食品与心血管风险之间的关系

食用植物性食物与心血管风险之间的关联

该研究强调,将加工肉和红肉(两者都与心血管疾病风险的增加有关)与家禽区分开来,家禽的适度摄入(每周最多3份,每份100克)与CVD风险没有关系。红肉(即牛肉、猪肉、羊肉)应限制在每周2份,每份100克,而加工肉(即熏肉、香肠、腊肠)应限制在偶尔使用。而豆类(每周最多四份,每份180克)可作为红肉的替代品。适度的鱼类消费(每周24份,每份150克)也得到了最新证据的支持,可以预防心脏病。另外,家禽可能是红肉的一个合适的蛋白质替代品,但要适量。

详情参考:2021 ESC科学饮食建议,怎么吃才能让心血管更健康!(建议收藏)

2. 未来10年心血管风险的新算法,了解一下?

欧洲心脏病学会(ESC)提供了指导方针,并倡导使用风险预测模型来加强医疗保健和全民预防。风险模型通常可用于估计10年内的个人风险,目的是确定那些应该从预防行动中获益最多的心血管疾病高危人群。

ESC已经召集了一项工作,以修订其推荐的风险预测算法,即系统性冠状动脉风险评估(SCORE5),以满足相互关联的需求。SCORE只包括致命的CVD结果,这意味着它低估了CVD的总负担,而近几十年来,CVD的负担已经转向非致命的结果,尤其是对年轻人而言。

为了解决这些局限性,SCORE2工作小组和ESC心血管风险合作组织提供了SCORE2的开发、验证和说明,以估计欧洲40-69岁无心血管疾病或糖尿病患者的10年致命和非致命心血管疾病风险。相关结果发表在《欧洲心脏杂志》(European Heart Journal)上。

预测的CVD风险在欧洲各地区有几倍的差异。例如,一个50岁的吸烟者,收缩压为140mmHg胆固醇为5.5mmol/L,高度脂蛋白胆固醇为1.35.5mmol/L,估计的10年心血管疾病风险从低风险国家男性的5.9%到非常高风险国家男性的14.0%不等,从低风险国家女性的4.2%到非常高风险国家女性的13.7%。

 

SCORE2图表用于估计欧洲四个风险地区的CVD风险

SCORE2是一种新的算法,用于预测欧洲人口中首发心血管疾病的10年风险,经过校准和验证,加强了对整个欧洲患心血管疾病的高风险个体的识别。

详情参考:EHJ:想知道未来10年心血管风险?来看看这个近千万人得出的新算法!

3. 益生菌对超重和肥胖个体心血管风险的有益影响

这项发表在Clinical Nutrition上的研究旨在评估益生菌补充剂对超重和肥胖受试者的体重、身体肥胖和 CVD 风险标志物的影响。

研究人员在各个数据库中对截至 2020 年 12 月发表的 随机对照实验(RCT) 进行了系统搜索。选择使用随机效应模型的荟萃分析来分析联合试验的影响。最后包括了 26 个 RCT研究(n=1720)。数据汇总显示益生菌对体重(MD:-0.70kg;95%CI:-1.04,-0.35kg;P <0.0001)、体重指数(BMI)(MD:-0.24kg/m2 ; 95%CI:-0.35,-0.12kg/m2 ; P =0.0001), 腰围 (WC) (MD:-1.13cm; 95%CI:-1.54,-0.73cm; P <0.0001), 脂肪量(MD:-0.71kg; 95%CI:-1.10,-0.32kg; P =0.0004), 肿瘤坏死因子-α (MD:-0.16pg/ml; 95%CI:-0.24,-0.08pg/ml; P =0.0001)、胰岛素(MD:-0.85mcU/ml;95%CI:-1.50、-0.21mcU/ml;P =0.010)、总胆固醇(MD:-0.16mmol/l;95%CI:-0.26 ,-0.05mmol/l; P=0.003) 和 低密度脂蛋白(LDL) (MD:-0.09mmol/l; 95%CI:-0.16,-0.03mmol/l; P =0.006) 的改善都有很大的作用。在使用单一和多种细菌物种的研究中,体重、BMI 和 WC也可以观察到显着降低。但是所有的变化都要在益生菌剂量≥ 1010 CFU 且持续时间≥ 8 周的研究中才能起到效果。

详情参考:Clinical Nutrition: 益生菌对超重和肥胖个体心血管风险具有有益影响

4. 油炸食品摄入量可能会增加心血管疾病的风险

近日,心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员进行了一项荟萃分析,包括剂量反应分析,以量化一般成年人群油炸食品摄入量与血管疾病风险和全因死亡率之间的关联。

最高和最低油炸食品摄入量相比较时,主要心血管事件的总RR(95%CI)为1.28(1.15至1.43;n=17,I2=82.0%)(前瞻性研究:1.24(1.12至1.38),n=13,I2=75.7%;病例对照研究:1.91(1.15至3.17),n=4,I2=92.1%);冠心病的总RR为1.22(1.07至1.40;n=11,I2=77.9%)(前瞻性研究:1.16(1.05至1.29),n=8,I2=44.6%;病例对照研究:1.91(1.05至3.47),n=3,I2=93.9%)。

森林图

卒中的总RR为1.37(0.97至1.94;n=4,I2=80.7%)(队列研究:1.21(0.87至1.69),n=3,I2=77.3%;病例对照研究:2.01(1.27至3.19),n=1);心力衰竭的总RR为1.37(1.07至1.75;n=4,I2=80.0%);心血管死亡率为1.02(0.93至1.14;n=3,I2=27.3%);全因死亡率为1.03(95%CI为0.96至1.12;n=6,I2=38.0%)。主要心血管事件、冠心病和心力衰竭之间的相关性呈线性。

由此可见,油炸食品摄入量可能会增加心血管疾病的风险,并呈现线性剂量-反应关系。

详情参考:Heart:油炸食品摄入量与心血管疾病风险和全因死亡率的关系

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1907762, encodeId=fa9f190e76215, content=<a href='/topic/show?id=fdcee0731d2' target=_blank style='color:#2F92EE;'>#疾病进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70731, encryptionId=fdcee0731d2, topicName=疾病进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sat May 14 13:22:38 CST 2022, time=2022-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004326, encodeId=b6681004326b9, content=荤素搭配要三七分。糖类尽量少食。饮食是保证健康的cVD加上科学性的运动。, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53b75484925, createdName=ms7000001515297003, createdTime=Sun Aug 01 04:33:08 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=998630, encodeId=4d3c99863059, content=好吧 我应该少吃肉 多吃菜, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f221859736, createdName=ms2658711348342440, createdTime=Sun Jul 11 21:33:50 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1277241, encodeId=eeeb12e724179, content=<a href='/topic/show?id=bde16242956' target=_blank style='color:#2F92EE;'>#梅斯#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62429, encryptionId=bde16242956, topicName=梅斯)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun Jul 11 06:22:38 CST 2021, time=2021-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498913, encodeId=f0af1498913d6, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sun Jul 11 06:22:38 CST 2021, time=2021-07-11, status=1, ipAttribution=)]
    2021-08-01 ms7000001515297003

    荤素搭配要三七分。糖类尽量少食。饮食是保证健康的cVD加上科学性的运动。

    0

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    2021-07-11 ms2658711348342440

    好吧 我应该少吃肉 多吃菜

    0

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    2021-07-11 一闲
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