American journal of preventive cardiology最新文献_第9页

Standard modifiable cardiovascular risk factors and coronary artery disease severity in adults with myocardial infarction ≤ 35 成人心肌梗死≤35的标准可改变心血管危险因素和冠状动脉疾病严重程度

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-15 DOI: 10.1016/j.ajpc.2025.101334

Si-qi Tang , Xin-long Zhao , Quan Li , Yan-bo Liu , Yi-tao Han , Yu-xiong Chen , Jin-yan Lei , Ya-kun Zhao , Zhong-jie Fan , Yan-ping Ruan

Background

Myocardial infarction (MI) in individuals ≤35 years is poorly characterized. The prevalence of standard modifiable cardiovascular risk factors (SMuRFs) and their associations with CAD severity at the index presentation and with post-index outcomes remain unclear.

Aims

We profiled SMuRFs in MI patients ≤35 years and assessed their association with CAD severity at the index MI and post-index outcomes.

Methods

This retrospective, two-center cohort study included index MI patients aged ≤35 years admitted to Beijing Anzhen Hospital and Peking Union Medical College Hospital between December 2011 and December 2021, and followed through February 2024. SMuRFs included hypertension, diabetes, hypercholesterolemia, and smoking. CAD severity was defined by the count of epicardial vessels with ≥50 % stenosis. Post-index event was major adverse cardiovascular and cerebrovascular events (MACCE).

Results

Among 776 patients (median age 33 years; 94 % male), 10 % had no SMuRFs, and 54 % had ≥2 SMuRFs. Smoking (74 %) and hypercholesterolemia (41 %) were most prevalent. Angiography revealed single-vessel disease in 47 %, two-vessel disease in 129 (17 %), and three-vessel disease in 194 (25 %); 11 % had no obstructive lesion. Each additional SMuRF increased the adjusted odds of more extensive CAD by 1.66-fold (95 % CI, 1.43–1.94). Diabetes, hypercholesterolemia, and hypertension were independently associated with multivessel disease, whereas smoking was not. Over a median follow-up of 5.6 years, 22.4 % experienced post-index MACCE, with higher incidence among patients with ≥3 SMuRFs.

Conclusions

Very young MI patients carry a high burden of SMuRFs, which correlate with greater CAD severity at the index presentation and worse post-index outcomes.

背景：≤35岁个体的心肌梗死（MI）特征不明确。标准可改变心血管危险因素（smurf）的患病率及其与冠心病严重程度的关系在指数表现和指数后的结果尚不清楚。目的：我们分析≤35岁的心肌梗死患者的smurf，并评估其与心肌梗死指数和指数后结果的CAD严重程度的关系。方法回顾性、双中心队列研究纳入2011年12月至2021年12月在北京安贞医院和北京协和医院住院的年龄≤35岁的MI患者，随访至2024年2月。smurf包括高血压、糖尿病、高胆固醇血症和吸烟。CAD的严重程度由狭窄程度≥50%的心外膜血管数量来确定。指数后事件为主要心脑血管不良事件（MACCE）。结果776例患者（中位年龄33岁，94%为男性）中，10%无smurf， 54% smurf≥2。吸烟（74%）和高胆固醇血症（41%）最为普遍。血管造影显示单血管病变47%，双血管病变129例（17%），三血管病变194例（25%）；11%没有梗阻性病变。每增加一次SMuRF，更广泛的CAD的调整几率增加1.66倍（95% CI, 1.43-1.94）。糖尿病、高胆固醇血症和高血压与多血管疾病独立相关，而吸烟与多血管疾病无关。在中位随访5.6年期间，22.4%的患者经历了指数后MACCE，在≥3个smurf的患者中发病率更高。非常年轻的心肌梗死患者携带较高的smurf负担，这与指数表现时较大的CAD严重程度和指数后较差的结果相关。

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引用次数: 0

The association of steatotic liver disease with cardiometabolic criteria and cardiovascular disease risk in a large cohort of people living with human immunodeficiency virus 在一大群人类免疫缺陷病毒感染者中，脂肪变性肝病与心脏代谢标准和心血管疾病风险的关系

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-15 DOI: 10.1016/j.ajpc.2025.101330

Richard K. Sterling , Alice L. Sternberg , Jordan E. Lake , Susanna Naggie , Sonya Heath , Jennifer C. Price , Laura Wilson , Holly Crandall , Samer Gawrieh , Naga Chalasani , Rohit Loomba , Mark Sulkowski , HIV NASH Clinical Research Network

Background & Aims

Steatotic liver disease (SLD), both metabolic dysfunction-associated liver disease (MASLD) without or with alcohol-associated liver disease (MetALD), is common in people with HIV (PWH) and associated with increased risk of cardiovascular disease (CVD).

Methods

Clinical and laboratory data were collected prospectively. MASLD was defined as SLD with ≥1 cardiometabolic risk factors (CMRF) and non-significant alcohol use. CVD risk was assessed by five 10-year risk scores (Framingham CVD score, 2013 ASCVD score, and PREVENT scores for total CVD, ASCVD, and heart failure) and one 5-year CVD score (D:A:D). Those without SLD were compared to MASLD and MetALD.

Results

Among 991 PWH without history of CVD, MASLD was present in 40% and MetALD in 9%. At least 4 CMRF were present in 55% of those with MASLD, 61% MetALD compared to 29% without SLD. Those with MASLD had higher PREVENT total CVD score than those without SLD and similarly for mean PREVENT ASCVD and heart failure scores. Those with MASLD also had higher mean risk than those without SLD by Framingham CVD score, 2013 ASCVD score, and D:A:D score. Conversely, those with MetALD and those without SLD had similar CVD risk scores. 10-year CVD risk level by PREVENT score was generally least.

Conclusions

CMRF are very common in PWH, with MASLD or MetALD frequently having multiple CMRF. The PREVENT scores showed higher 10-year CVD, ASCVD, and heart failure risk in those with MASLD versus those without SLD.

背景和目的脂肪变性肝病（SLD），即代谢功能障碍相关肝病（MASLD），不伴或伴酒精相关肝病（MetALD），常见于HIV （PWH）患者，并与心血管疾病（CVD）风险增加相关。方法前瞻性收集临床及实验室资料。MASLD被定义为具有≥1个心脏代谢危险因素（CMRF）和无显著酒精使用的SLD。CVD风险通过5个10年风险评分（Framingham CVD评分、2013年ASCVD评分和预防总CVD、ASCVD和心力衰竭评分）和一个5年CVD评分（D:A:D）来评估。无SLD患者与MASLD和MetALD患者进行比较。结果991例无心血管病史的PWH患者中，MASLD占40%，MetALD占9%。55%的MASLD患者存在至少4个CMRF， 61%的MetALD患者存在至少4个CMRF，而没有SLD的患者为29%。MASLD患者的心血管疾病预防总评分高于无SLD患者，ASCVD和心力衰竭的平均预防评分也相似。根据Framingham CVD评分、2013年ASCVD评分和D:A:D评分，MASLD患者的平均风险也高于无slld患者。相反，患有MetALD和没有SLD的人有相似的心血管疾病风险评分。预防评分的10年心血管疾病风险水平普遍最低。结论PWH患者多发CMRF， MASLD或MetALD患者多发CMRF。预防评分显示，MASLD患者的10年心血管疾病、ASCVD和心力衰竭风险高于无slld患者。

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引用次数: 0

High lipoprotein(a) is associated with elevated arachidonic acid levels 高脂蛋白(a)与花生四烯酸水平升高有关

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-14 DOI: 10.1016/j.ajpc.2025.101333

Waqas A. Malick , Phyu Mar , Chen Gurevitz , Jay Krishna Katragadda , Honey Zaw , Sascha N. Goonewardena , Robert S. Rosenson

引用次数: 0

AJPC family heart summit special issue: guest editor overview / message AJPC家心峰会特刊：特邀编辑概述/留言

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-13 DOI: 10.1016/j.ajpc.2025.101331

Laurence S. Sperling , Martha Gulati

引用次数: 0

Utility of coronary artery calcium scoring in low-risk patients: The Multi-Ethnic Study of Atherosclerosis (MESA) 冠状动脉钙评分在低危患者中的应用：多民族动脉粥样硬化研究（MESA）

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-13 DOI: 10.1016/j.ajpc.2025.101329

Jonathan R. Davis , Alexander C. Razavi , Charlotte C. Ellberg , Michael J. Blaha , Michael H. Criqui , Harpreet S. Bhatia

Background

Guidelines recommend consideration of coronary artery calcium (CAC) scoring in intermediate atherosclerotic cardiovascular disease (ASCVD) risk patients, but its utility in lower-risk individuals is less clear.

Methods

Data from 6712 participants from MESA was used with 10-year ASCVD risk defined by the pooled cohort equations (PCE) and AHA PREVENT equations. The association between CAC, CHD and ASCVD risk was evaluated using Cox proportional hazard models. Risk prediction improvement was evaluated using Harrell’s C-index and net reclassification improvement (NRI).

Results

Amongst all participants (mean age 62.2 ± 10.2 years, 52.8 % women), the ASCVD event rate per 1000 person years was 14.3 vs. 4.1 with and without CAC over a median of 16.7 years. CAC score was most strongly associated with increased ASCVD risk in low and borderline-risk individuals (HR 1.35, 95 % CI 1.22–1.50 and 1.30, 1.16–1.46). Among these individuals, addition of the Agatston score to the PCE improved the C-index (SE) for ASCVD from 0.593(0.029) to 0.640(0.031) and 0.558(0.037) to 0.663(0.036), respectively. Category-free NRI was also significant in low (0.3268, 95 % CI 0.0960–0.5408) and borderline (0.4283, 0.2319–0.7332) risk individuals with similar results using the AHA PREVENT equations. Using a statin eligibility threshold of 7.5 %, the addition of CAC correctly reclassified a net of 10.1 % of low/borderline risk individuals vs the PCE and 16.7 % vs. PREVENT.

Conclusions

CAC is associated with increased ASCVD risk in lower-risk individuals. The addition of CAC scoring to the PCE and AHA PREVENT equations improved risk prediction, suggesting potential utility in this population.

指南建议在中度动脉粥样硬化性心血管疾病（ASCVD）风险患者中考虑冠状动脉钙（CAC）评分，但其在低风险个体中的应用尚不清楚。方法来自MESA的6712名参与者的数据采用合并队列方程（PCE）和AHA PREVENT方程定义的10年ASCVD风险。采用Cox比例风险模型评估CAC、冠心病和ASCVD风险之间的关系。采用Harrell’s c指数和净再分类改善（NRI）评价风险预测改善程度。结果在所有参与者中（平均年龄62.2±10.2岁，52.8%为女性），每1000人年的ASCVD事件发生率为14.3 vs 4.1，中位年龄为16.7年。在低危和边缘危人群中，CAC评分与ASCVD风险增加的相关性最强（HR 1.35, 95% CI 1.22-1.50和1.30,1.16-1.46）。加Agatston评分后，ASCVD的c指数（SE）分别从0.593（0.029）提高到0.640(0.031)，从0.558（0.037）提高到0.663（0.036）。无类别NRI在低风险个体（0.3268,95% CI 0.0960-0.5408）和临界风险个体（0.4283,0.2319-0.7332）中也具有显著性，使用AHA PREVENT方程的结果相似。使用7.5%的他汀类药物资格阈值，添加CAC正确地重新分类了10.1%的低/边缘风险个体与PCE和16.7%的预防风险个体。结论scac与低危人群ASCVD风险增加相关。在PCE和AHA PREVENT方程中加入CAC评分提高了风险预测，表明在这一人群中具有潜在的实用性。

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引用次数: 0

Erectile dysfunction and cardiovascular-kidney-metabolic syndrome: Insights from the all of us research program 勃起功能障碍和心血管-肾脏-代谢综合征：来自我们所有研究项目的见解

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-12 DOI: 10.1016/j.ajpc.2025.101332

Cameron M. Blazoski , Zhiqi Yao , Tobias S. Kohler , Martin M. Miner , John Erhabor , Michael J. Blaha

Introduction

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) risk factors and is a potential indicator for future CVD events, but ED’s association with cardiovascular-kidney-metabolic (CKM) syndrome has not been systematically studied.

Methods

This study used data from the All of Us Research Program covering 2017 to 2023. The primary exposure was prevalence of electronic health record-diagnosed ED with cross-sectional analyses measuring the association between prevalent ED and prevalent CKM conditions. In participants without CKM conditions at baseline, we performed survival analyses to evaluate the association between prevalent ED and the development of future CKM conditions with a follow up period ranging from a median of 2.1–4.0 years.

Results

Of the 97,475 male participants in this study, 5,575 (5.7 %) had a documented baseline ED diagnosis. The highest prevalence by race was white individuals (7.2 %) and by age range was 75–80 (12.7 %). Participants with ED versus those without ED had a higher rate of CKM conditions including diabetes mellitus (T2DM) (19.3 % vs 7.3 %), hypertension (HTN) (47.6 % vs 18.8 %), chronic kidney disease (CKD) (10.3 % vs 2.8 %), heart failure (HF) (5.7 % vs 2.0 %), atherosclerotic cardiovascular disease (ASCVD) (3.0 % vs 1.3 %), and atrial fibrillation (AF) (7.3 % vs 2.5 %). Baseline prevalent ED was associated with higher risks of developing CKM conditions of CKD, HF, AF, ASCVD, and HTN but not the development of T2DM.

Conclusion

A diagnosis of ED was significantly associated with both the prevalence and future development of cardiovascular and metabolic conditions, suggesting that ED assessment should be incorporated into routine cardiometabolic risk evaluation.

勃起功能障碍（ED）与心血管疾病（CVD）危险因素相关，是未来CVD事件的潜在指标，但ED与心血管肾代谢（CKM）综合征的关系尚未系统研究。本研究使用了2017年至2023年“我们所有人研究计划”的数据。主要暴露是电子健康记录诊断的ED的流行，并通过横断面分析测量流行ED与流行CKM状况之间的关联。在基线时无CKM条件的参与者中，我们进行了生存分析，以评估流行ED与未来CKM条件发展之间的关系，随访时间中位数为2.1-4.0年。结果在这项研究的97475名男性参与者中，5575名（5.7%）有记录的ED基线诊断。按种族划分的患病率最高的是白人（7.2%），按年龄划分的患病率最高的是75-80岁（12.7%）。与没有ED的参与者相比，ED患者的CKM疾病发生率更高，包括糖尿病（T2DM）（19.3%对7.3%）、高血压（HTN）（47.6%对18.8%）、慢性肾病（CKD）（10.3%对2.8%）、心力衰竭（HF）（5.7%对2.0%）、动脉粥样硬化性心血管疾病（ASCVD）（3.0%对1.3%）和心房颤动（AF）（7.3%对2.5%）。基线流行ED与发生CKD、HF、AF、ASCVD和HTN等CKM状况的高风险相关，但与发生T2DM无关。结论ED的诊断与心血管和代谢疾病的患病率及未来发展均有显著相关性，提示ED评估应纳入常规心脏代谢风险评估。

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引用次数: 0

Over-the-counter access to combined oral contraceptives for individuals with hypertension: an expert review 高血压患者非处方获得联合口服避孕药：专家综述

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-10 DOI: 10.1016/j.ajpc.2025.101328

Kate Grindlay , Katherine Key , Raegan McDonald-Mosley , Melissa Kottke , Dázon Dixon Diallo , Martha Gulati , Daniel Grossman

Efforts are underway to move a combined oral contraceptive over the counter in the United States. However, hypertension is an important contraindication and questions exist regarding how users should screen for it in an over-the-counter setting. An expert panel convened in April 2022 to review the literature related to hypertension and an over-the-counter switch for combined oral contraceptives and vote on a set of blood pressure screening recommendations for future over-the-counter combined oral contraceptives. Research indicates that people can accurately self-screen for contraindications to combined oral contraceptives using simple checklists, and the absolute risk of adverse events is low among people with hypertension who use combined oral contraceptives and must be balanced against substantially higher risks of pregnancy as well as benefits of increased contraceptive access. Based on these data, the panel concluded that 1) individuals who have not had their blood pressure checked in the last year or do not know their blood pressure should be advised in product labeling to get it checked prior to purchase; 2) blood pressure documentation should not be required to purchase over-the-counter combined oral contraceptives, provided over-the-counter switch behavioral studies demonstrate individuals can correctly self-screen for use; and 3) blood pressure screening should be made more accessible and affordable. Over-the-counter combined oral contraceptives may increase access to the most commonly used reversible contraceptive method. They may also provide an opportunity for enhanced education and awareness of hypertension and preventive cardiovascular screenings among people of reproductive age, particularly young people and people of color.

美国正在努力将一种复方口服避孕药推向非处方。然而，高血压是一个重要的禁忌症，存在关于使用者如何在非处方环境中筛查高血压的问题。一个专家小组于2022年4月召开会议，审查与高血压和非处方联合口服避孕药转换相关的文献，并就未来非处方联合口服避孕药的一套血压筛查建议进行投票。研究表明，人们可以使用简单的检查表准确地自我筛选联合口服避孕药的禁忌症，并且在使用联合口服避孕药的高血压患者中，不良事件的绝对风险很低，必须与怀孕风险大幅增加以及增加获得避孕药具的好处相平衡。根据这些数据，专家组得出结论：1)在过去一年中没有测量过血压的人，或者不知道自己的血压的人，应该在产品标签上被建议在购买前进行测量；2)购买非处方联合口服避孕药不应要求血压记录，前提是非处方切换行为研究表明个体能够正确地自我筛查使用；3)血压筛查应该更容易获得和负担得起。非处方联合口服避孕药可能增加获得最常用的可逆避孕方法的机会。它们还可以为育龄人群，特别是年轻人和有色人种，提供机会，加强对高血压和预防性心血管筛查的教育和认识。

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引用次数: 0

Greater amount of lying and reclining associate with cardiovascular disease risk score and several risk factors, while short sitting bouts and standing have opposite relation 躺卧时间长与心血管疾病风险评分及多个危险因素相关，而久坐时间短与站立时间相反

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-09 DOI: 10.1016/j.ajpc.2025.101327

Pauliina Husu , Henri Vähä-Ypyä , Kari Tokola , Harri Sievänen , Onni Niemelä , Tommi Vasankari

Excess sedentary behavior (SB) seems to be harmful for health, whereas the effects of standing can be opposite. The present study aimed at 1) describing different components of SB (lying, reclining, sitting) and standing accumulating from different bout lengths in a population-based sample and 2) analyzing their associations with indicators of cardiometabolic health. The study is based on cross-sectional accelerometer-measured data on 24/7 physical behavior among 20–69-year-old Finns. Outcomes were Framingham score for cardiovascular disease (CVD) risk, serum high (HDL)- and low-density lipoprotein (LDL) and total cholesterol, triglycerides, and waist circumference. Participants (n = 4298) mean age was 51 years (SD=13) and 61 % were female. More lying and reclining, regardless of bout length, were associated with higher CVD-score (p ≤ 0.001), lower HDL-cholesterol (p < 0.001), higher triglycerides (p < 0.001) and larger waist circumference (p < 0.001). Longer sitting time accumulating from <30 min bouts was associated with lower CVD-score (p < 0.001), higher HDL- (p < 0.001), lower LDL- (p = 0.004) and total cholesterol (p = 0.009), lower triglycerides (p < 0.001) and smaller waist circumference (p < 0.001). Longer sitting accumulating from bouts exceeding 20 min was associated with larger waist circumference (p < 0.001) indicating that health associations of sitting may depend on bout length. More standing regardless of bout length was associated with lower CVD-score (≤0.001), higher HDL-cholesterol (p < 0.001), lower triglycerides (p < 0.001) and smaller waist circumference (p < 0.001). These associations were mostly independent of moderate-to-vigorous physical activity. Lying and reclining had negative associations with CVD-score and risk factors while short sitting bouts and standing had positive associations, underpinning the importance of evaluating the different components of stationary behavior separately without combining them to overall SB.

过多的久坐行为（SB）似乎对健康有害，而站立的影响可能恰恰相反。本研究旨在1)描述在以人群为基础的样本中，不同体态长度累积的SB（躺着、躺着、坐着）和站立的不同成分，2)分析它们与心脏代谢健康指标的关系。这项研究是基于20 - 69岁芬兰人24小时身体行为的横截面加速度计测量数据。结果是心血管疾病（CVD）风险、血清高（HDL）和低密度脂蛋白（LDL）、总胆固醇、甘油三酯和腰围的Framingham评分。参与者（n = 4298）平均年龄为51岁（SD=13）， 61%为女性。更多的躺卧和斜倚，无论长度，与更高的cvd评分（p≤0.001），更低的高密度脂蛋白胆固醇（p < 0.001），更高的甘油三酯（p < 0.001）和更大的腰围（p < 0.001）相关。从30分钟开始累积的较长静坐时间与较低的cvd评分（p < 0.001）、较高的HDL- (p < 0.001)、较低的LDL- (p = 0.004)和总胆固醇（p = 0.009）、较低的甘油三酯（p < 0.001）和较小的腰围（p < 0.001）相关。超过20分钟的回合累积的久坐时间与较大的腰围相关（p < 0.001），表明久坐的健康关联可能取决于回合长度。不论回合长度，站立时间越长，cvd评分越低（≤0.001），hdl -胆固醇越高（p < 0.001），甘油三酯越低（p < 0.001），腰围越小（p < 0.001）。这些关联大多独立于中等到剧烈的体育活动。躺着和躺着与cvd评分和风险因素呈负相关，而短时间坐着和站立有正相关，这表明单独评估静止行为的不同组成部分的重要性，而不是将它们与整体SB结合起来。

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引用次数: 0

Global trends in cardiovascular mortality attributable to high body mass index: 1990–2021 analysis with future projections 高体重指数导致的心血管疾病死亡率的全球趋势：1990-2021年分析及未来预测

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-07 DOI: 10.1016/j.ajpc.2025.101326

Parisa Fallahtafti , Hamidreza Soleimani , Shaghayegh Khanmohammadi , Amirhossein Habibzadeh , Morvarid Taebi , Alireza Azarboo , Amirhossein Shirinezhad , Aysan Valinejad , Michael J. Blaha , Sadeer Al-Kindi , Khurram Nasir

Objective

Cardiovascular disease (CVD) remains a major global cause of death, with high body mass index (BMI) as a key modifiable risk factor. This study examines global and regional patterns of CVD mortality attributable to high BMI from 1990 to 2021, with projections to 2032.

Methods

Using Global Burden of Disease 2021 data from 204 countries, we analyzed age-standardized mortality rates (ASMRs) and population-attributable fractions by sex, age, socio-demographic index (SDI), and region. Future trends were estimated using a Bayesian age-period-cohort model, with uncertainity intervals from 1000 posterior simulations.

Results

High BMI-related deaths due to CVD rose from 0.9 million in 1990 to 1.9 million in 2021, with ASMR declining from 24.43 to 22.77 per 100,000 (-6.83 %). High-middle SDI regions had the highest ASMR, while low-middle SDI regions saw the largest increase. Mortality rose for hypertensive heart disease and atrial fibrillation and flutter, but declined for ischemic heart disease and stroke. Older adults accounted for most deaths, though ASMR increased among those aged 15–49. By 2032, deaths are projected to reach 2.5 million (+33 %), with ASMR dropping to 22.06.

Conclusion

Despite modest ASMR declines, high-BMI-related CVD deaths are rising, especially in low-SDI regions, underscoring the need for targeted prevention.

目的心血管疾病（CVD）仍然是全球主要的死亡原因，高体重指数（BMI）是一个关键的可改变的危险因素。本研究调查了1990年至2021年全球和区域高BMI导致的心血管疾病死亡率模式，并预测到2032年。方法使用来自204个国家的全球疾病负担2021数据，按性别、年龄、社会人口指数（SDI）和地区分析年龄标准化死亡率（ASMRs）和人口归因部分。使用贝叶斯年龄-时期-队列模型估计未来趋势，1000次后验模拟的不确定区间。结果心血管疾病导致的高bmi相关死亡人数从1990年的90万上升到2021年的190万，ASMR从24.43 / 10万下降到22.77 / 10万（- 6.83%）。中高SDI区域的ASMR最高，而中低SDI区域的ASMR增幅最大。高血压心脏病、心房颤动和心房扑动的死亡率上升，但缺血性心脏病和中风的死亡率下降。老年人占死亡人数最多，尽管15-49岁的人群中ASMR增加。到2032年，预计死亡人数将达到250万（增加33%），ASMR降至22.06。结论：尽管ASMR略有下降，但高bmi相关的心血管疾病死亡人数仍在上升，特别是在低sdi地区，这强调了有针对性预防的必要性。

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引用次数: 0

Validity of self-assessment tools for cardiovascular risk behaviors: A systematic review 心血管危险行为自我评估工具的有效性：一项系统综述

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology

Pub Date : 2025-10-07 DOI: 10.1016/j.ajpc.2025.101316

Wilhelmina F. Goevaerts , Joyce M. Heutinck , Mayke M.C.J. Van Leunen , Wessel W. Nieuwenhuys , Lonneke A. Fruytier , Cyrille Herkert , Jos J. Kraal , Ilse A.G. Rongen , Willem J. Kop , Yuan Lu , Hareld M.C. Kemps , Rutger W.M. Brouwers

Background

A healthy lifestyle is crucial in mitigating cardiovascular disease risk. Numerous tools for cardiovascular risk behaviors have been developed that people can use for self-assessment purposes. However, the validity of these tools is insufficiently understood in the context of self-assessment. This systematic review examines the validity of self-assessment tools for cardiovascular risk behaviors, including lack of physical activity (PA), tobacco smoking, excessive alcohol consumption, unhealthy diet, and chronic psychological stress.

Methods

The PubMed, Ovid Embase, and the Cochrane Library databases were searched. Studies investigating the validity of tools in the context of self-assessment (i.e., without active involvement of a healthcare professional) were included. We investigated criterion validity (i.e., comparison to a gold standard), convergent validity (comparison to similar measures), face and content validity, and reliability.

Results

Thirty-one unique articles reporting on 37 separate validation studies were included, which examined a total of 49 distinct self-assessment tools (with tools for PA (n = 40), nutritional intake (n = 7), psychological stress (n = 1), and multiple domains (n = 1)). No validation studies were found for self-assessment of tobacco smoking or alcohol consumption. All wearable PA intensity assessment–energy expenditure studies demonstrated weak validity, both in laboratory and free-living conditions. Criterion validity was examined for only two nutritional intake tools, showing weak to moderate validity. For psychological stress and tools measuring multiple domains, only convergent validity was examined.

Discussion

Behavioral self-assessment tools are predominantly focused on PA and nutritional intake, with limited evidence for good validity. There is a pressing need for developing and validating comprehensive and accurate self-assessment tools.

健康的生活方式对降低心血管疾病风险至关重要。人们已经开发了许多用于自我评估心血管风险行为的工具。然而，在自我评估的背景下，这些工具的有效性还没有得到充分的理解。本系统综述探讨了心血管风险行为的自我评估工具的有效性，包括缺乏身体活动（PA）、吸烟、过度饮酒、不健康饮食和慢性心理压力。方法检索PubMed、Ovid Embase和Cochrane Library数据库。在自我评估的背景下（即没有医疗保健专业人员的积极参与）调查工具有效性的研究包括在内。我们调查了标准效度（即与金标准的比较），收敛效度（与类似措施的比较），面效度和内容效度以及信度。结果共纳入37项独立验证研究的31篇独特文章，共检查了49种不同的自我评估工具（包括PA （n = 40）、营养摄入（n = 7）、心理压力（n = 1）和多领域（n = 1）的工具）。没有发现吸烟或饮酒自我评估的验证性研究。所有可穿戴PA强度评估-能量消耗研究在实验室和自由生活条件下都显示出较弱的有效性。标准效度仅对两种营养摄入工具进行了检验，显示弱效度至中等效度。对于心理压力和多领域测量工具，只检验了收敛效度。讨论行为自我评估工具主要集中在PA和营养摄入，有限的证据证明良好的有效性。迫切需要开发和验证全面和准确的自我评估工具。

{"title":"Validity of self-assessment tools for cardiovascular risk behaviors: A systematic review","authors":"Wilhelmina F. Goevaerts , Joyce M. Heutinck , Mayke M.C.J. Van Leunen , Wessel W. Nieuwenhuys , Lonneke A. Fruytier , Cyrille Herkert , Jos J. Kraal , Ilse A.G. Rongen , Willem J. Kop , Yuan Lu , Hareld M.C. Kemps , Rutger W.M. Brouwers","doi":"10.1016/j.ajpc.2025.101316","DOIUrl":"10.1016/j.ajpc.2025.101316","url":null,"abstract":"<div><h3>Background</h3><div>A healthy lifestyle is crucial in mitigating cardiovascular disease risk. Numerous tools for cardiovascular risk behaviors have been developed that people can use for self-assessment purposes. However, the validity of these tools is insufficiently understood in the context of self-assessment. This systematic review examines the validity of self-assessment tools for cardiovascular risk behaviors, including lack of physical activity (PA), tobacco smoking, excessive alcohol consumption, unhealthy diet, and chronic psychological stress.</div></div><div><h3>Methods</h3><div>The PubMed, Ovid Embase, and the Cochrane Library databases were searched. Studies investigating the validity of tools in the context of self-assessment (i.e., without active involvement of a healthcare professional) were included. We investigated criterion validity (i.e., comparison to a gold standard), convergent validity (comparison to similar measures), face and content validity, and reliability.</div></div><div><h3>Results</h3><div>Thirty-one unique articles reporting on 37 separate validation studies were included, which examined a total of 49 distinct self-assessment tools (with tools for PA (<em>n =</em> 40), nutritional intake (<em>n =</em> 7), psychological stress (<em>n =</em> 1), and multiple domains (<em>n =</em> 1)). No validation studies were found for self-assessment of tobacco smoking or alcohol consumption. All wearable PA intensity assessment–energy expenditure studies demonstrated weak validity, both in laboratory and free-living conditions. Criterion validity was examined for only two nutritional intake tools, showing weak to moderate validity. For psychological stress and tools measuring multiple domains, only convergent validity was examined.</div></div><div><h3>Discussion</h3><div>Behavioral self-assessment tools are predominantly focused on PA and nutritional intake, with limited evidence for good validity. There is a pressing need for developing and validating comprehensive and accurate self-assessment tools.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101316"},"PeriodicalIF":5.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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