Report redefines overlapping risks of heart and kidney diseases
By American Heart Association 线上电子游戏飞禽走兽
理由是受影响的人数众多，造成严重的健康后果, heart health experts are redefining the overlapping effects of obesity, 2型糖尿病, 慢性肾脏疾病和心血管疾病，并重新思考它们如何预测长期心血管风险.
A 总统顾问 from the American Heart Association, published Monday in the journal Circulation, defines the overlap as cardiovascular-kidney-metabolic syndrome, 或CKM综合征. 该建议还建议更新风险计算器，帮助医疗保健专业人员预测一个人患心脏病或中风的可能性.
CKM affects nearly every major organ, 包括大脑, 肾脏和肝脏, and the cardiovascular system. It affects blood vessels and heart muscle function, the rate of fatty buildup in arteries, electrical impulses in the heart and more.
The advisory spells out stages of CKM, 范围从0, where there are no risk factors and the focus is on prevention, to 4, which may include kidney failure. Treatments are specified for each stage.
“肾脏和代谢疾病的筛查将帮助我们更早地开始保护性治疗，以最有效地预防心脏病，并最好地管理现有的心脏病。," Dr. Chiadi E. Ndumele, who led the expert panel that wrote the advisory, said in a 线上电子游戏飞禽走兽发布会上.
该建议特别关注CKM综合征早期阶段的患者, 说Ndumele, 他是巴尔的摩约翰霍普金斯大学心脏病学部门的医学副教授和肥胖和心脏代谢研究主任.
2型糖尿病和肥胖是代谢性疾病(CKM中的“M”)，也是心血管疾病的危险因素, 2型糖尿病和慢性肾病患者最常见的死亡原因是什么.
CKM综合征是成人和青少年中肥胖和2型糖尿病历史高发的结果, 咨询说. According to AHA statistics, a third of U.S. 成年人有三种或三种以上导致心血管疾病的危险因素, metabolic disorders and kidney disease.
该咨询告知卫生保健专业人员和公众有关管理该综合征的最佳方法, Ndumele说. “我们现在有几种治疗方法可以预防肾脏疾病和心脏病的恶化."
该咨询强调，人们可以采取措施限制或减少CKM综合征的危害，并且这样做的最佳线上电子游戏飞禽走兽是在早期阶段.
The stages are defined as:
Stage 0 – No CKM risk factors. The goal at this stage is to prevent CKM syndrome through healthy eating, physical activity and sleep habits, avoiding nicotine and maintaining optimal weight, 血压, blood sugar and cholesterol levels.
Stage 1 – A person has excess body fat, an unhealthy distribution of body fat, such as abdominal obesity, or impaired glucose tolerance or prediabetes. 在这个阶段, lifestyle changes and a goal of at least 5% weight loss are suggested, along with treatment for glucose intolerance if needed.
Stage 2 – This stage includes people with 2型糖尿病, 高血压, high triglycerides or kidney disease. 护理的目标是治疗这些疾病，以防止进展为心血管疾病和肾衰竭.
第三阶段——这一阶段的人有早期心血管疾病，没有症状, as well as metabolic risk factors, kidney disease or a high predicted risk for cardiovascular disease. 加强预防进展为有症状的心血管疾病和肾衰竭的努力可能包括增加或改变药物，并额外关注生活方式的改变.
Stage 4 – In this stage, people have cardiovascular disease with symptoms and excess body fat, metabolic risk factors or kidney disease. 人们可能已经有心脏病发作或中风，或者可能已经有心力衰竭, peripheral artery disease or atrial fibrillation. 第4阶段分为有肾功能衰竭和无肾功能衰竭的亚类别.
该建议提出了不同专业的专业人员可以更好地合作的方法, Ndumele说, and emphasizes the importance of addressing social factors, such as nutrition insecurity and opportunities for exercise. 一个单独的 科学声明同样发表在《线上娱乐电子游戏网站》(Circulation)杂志上的论文，详细阐述了该建议中概述的方法的证据.
该建议还建议更新心血管疾病风险计算器，以包括肾功能的测量, 2型糖尿病 control and social determinants of health.
The current calculator, known as the Pooled Cohort Equation, 自2013年以来一直用于帮助预测40至75岁人群在未来10年内心脏病发作或中风的风险. 该方程包括一个人的健康和人口因素，并用于指导生活方式建议和治疗决策.
该建议还建议在30岁以下的年轻人中使用这种新的风险工具, calculate both 10- and 30-year cardiovascular risk, and be expanded to predict for heart failure, a condition where the heart can't pump efficiently.
The advisory also calls for systemic changes to address CKM.
“我们有必要从根本上改变教育卫生保健专业人员和公众的方式, how we organize care and how we reimburse care related to CKM syndrome,恩杜梅尔说.