新工具给心血管疾病预测带来巨大变化

Experts have unveiled a new tool to predict a person's long-term risk of cardiovascular disease, one that includes broader measures of health and provides sex-specific results but leaves out considerations of race.

新工具, 或者风险计算器, 评估心脏病发作的风险, 中风和心脏衰竭——这是这种计算器第一次出现这种情况. 它还考虑了心血管疾病的新测量方法, 肾脏疾病和代谢疾病, 包括2型糖尿病和肥胖症.

与现有的计算器进行比较, the new version allows health professionals to evaluate younger people and look further into the future.

Details about the calculator were published Friday in the journal Circulation as a 科学声明 from the 美国心脏协会 alongside a paper detailing the development, 新工具的测试和公式. The new AHA risk calculator will help doctors evaluate health risks and may help people receive care earlier to reduce them, Dr. Sadiya年代. Khan, chairperson of the committee that wrote the statement, said in a news release.

风险计算器允许医疗保健专业人员使用健康数据, 比如血压和胆固醇水平, as well as demographic and socioeconomic information to produce a risk estimate or score. 这些新公式是根据来自600多万美国学生的数据开发出来的.S. adults from a variety of racial and ethnic, socioeconomic and geographic backgrounds.

新的计算器包含了 cardiovascular-kidney-metabolic综合症这是第一次 由美国心脏协会定义 10月. CKM syndrome comes in five stages; people with it are at higher risk of heart attack, 每个阶段都有中风或心力衰竭. 随着CKM综合征基础条件的恶化，风险增加. 根据美国心脏协会的统计，每3个美国人中就有1个.S. 成年人有三种或更多的风险因素会导致这种综合征.

这种新的计算器叫做PREVENT, 即预测心血管疾病线上娱乐电子游戏网站的风险. 一个在线工具正在开发中.

以前的心血管疾病风险计算器, 合并队列方程, 于2013年发布. But new treatments have since become available for conditions such as obesity, 2型糖尿病和肾病, 可汗说:.

“我们需要一种新的心血管疾病风险计算器, 特别是包括CKM综合征的测量,汗说。. She is a preventive cardiologist at Northwestern Medicine and an associate professor at Northwestern University's Feinberg School of Medicine, 都在芝加哥.

除了血压和胆固醇水平, the new calculator incorporates measures of blood sugar and kidney function. 它还询问了烟草使用情况以及人们是否服用药物, 它还会影响一个人的年龄和性别.

The new calculator can assess people from ages 30 to 79 and can predict risk for heart attack, 中风和心力衰竭在接下来的10年和30年. The previous calculator was designed for people starting at age 40 and looked only 10 years ahead.

"Longer-term estimates are important because short-term or 10-year risk in most young adults is still going to be low. We wanted to think more broadly and apply a life-course perspective,汗说。. "Providing information on 30-year risk may reveal earlier opportunities for intervention and prevention efforts in younger people."

新的计算器区分了不同生物性别的风险. Although there are clear racial and ethnic disparities in risk factors and in the incidence of cardiovascular disease, 新计算器的方程式中不包括种族. The AHA statement acknowledges race as a social factor and not a biological variable, 这意味着它不是预测风险的有效因素.

然而, PREVENT has an option to include an index that incorporates measures such as education, 贫困, 失业和基于个人环境的因素, 新的计算器在种族和民族群体中也有类似的准确性.

Khan called the new equations "a critical first step toward including CKM health and social factors in risk prediction" for cardiovascular disease.

"The Pooled Cohort Equations were developed with data from only white and Black adults and had separate equations for people of each race,汗说。. "There was not a risk model 为个人 from other race and ethnicity groups, 所以我们可能没有准确估计很多人的风险."

“我们也承认这种种族主义, 而不是种族, 在多个层面上起作用，增加患心血管疾病的风险, 可汗说:, and that more research is needed to determine the factors that underlie racial differences in risks and outcomes.

新的计算器还包括预测心力衰竭的措施, 心脏不能正常跳动的一种状况. 肥胖人群中, 2型糖尿病或肾病, the risk for heart failure can be higher than the risk for heart attack or stroke.

可汗说: PREVENT's estimates "should prompt conversations between health professionals and patients to increase awareness of CKM health status and CVD risk, and to translate that awareness into actions that improve health and reduce risk." Such actions could include lifestyle changes such as engaging in physical activity and eating healthy foods. 如果合适的话，还可以包括药物治疗.