报告重新定义了心脏和肾脏疾病的重叠风险

Citing the vast number of people affected and the serious health consequences, 心脏健康专家正在重新定义肥胖的多重影响, 2型糖尿病, chronic kidney disease and cardiovascular disease and rethinking how they predict long-term cardiovascular risks.

A 总统顾问 来自美国心脏协会, 周一发表在《线上电子游戏飞禽走兽》杂志上, 将重叠定义为心血管-肾脏-代谢综合征, 或CKM综合征. The advisory also suggests updates to the risk calculator that helps health care professionals predict a person's likelihood of having a heart attack or stroke.

慢性粒细胞白血病几乎影响到每一个主要器官, 包括大脑, 肾脏和肝脏, 心血管系统. 它会影响血管和心肌功能, 动脉中脂肪堆积的速度, 心脏的电脉冲等等.

该建议详细说明了CKM的各个阶段, 范围从0, 哪里没有危险因素，重点是预防, to 4, 其中可能包括肾衰竭. 为每个阶段指定处理方法.

"Screening for kidney and metabolic disease will help us start protective therapies earlier to most effectively prevent heart disease and best manage existing heart disease," Dr. Chiadi E. Ndumele是撰写该建议的专家小组的负责人，他在一份声明中说 线上电子游戏飞禽走兽发布会上.

The advisory is particularly focused on identifying people in early stages of CKM syndrome, 说Ndumele, an associate professor of medicine and director of obesity and cardiometabolic research in the division of cardiology at Johns Hopkins University in Baltimore.

2型糖尿病 and obesity are metabolic conditions — the "M" in CKM — and also are risk factors for cardiovascular disease, which is the most common cause of death for people with 2型糖尿病 and chronic kidney disease.

CKM syndrome is a consequence of the historically high prevalence of obesity and 2型糖尿病 in adults and youth, 咨询说. 根据美国心脏协会的统计，三分之一的美国人.S. adults has three or more risk factors that contribute to cardiovascular disease, 代谢紊乱和肾脏疾病.

The advisory informs health care professionals and the general public about the best ways to manage the syndrome, Ndumele说. "We now have several therapies that prevent both worsening kidney disease and heart disease."

The advisory emphasizes that people can take steps to limit or reduce the harm from CKM syndrome and that the best time to do so is in its early stages.

阶段定义为:

0期-无CKM危险因素. 这个阶段的目标是通过健康饮食来预防CKM综合征, 身体活动和睡眠习惯, 避免尼古丁，保持最佳体重, 血压, 血糖和胆固醇水平.

第一阶段:身体脂肪过多, 不健康的身体脂肪分布, 比如腹部肥胖, 或葡萄糖耐量受损或前驱糖尿病. 在这个阶段, 建议改变生活方式，并设定至少减重5%的目标, 如果需要的话还可以治疗葡萄糖耐受不良.

第二阶段:这一阶段包括2型糖尿病患者, 高血压, 高甘油三酯或肾脏疾病. The goal of care is to treat these conditions to prevent progression to cardiovascular disease and kidney failure.

Stage 3 – People in this stage have early cardiovascular disease without symptoms, 以及代谢风险因素, 肾脏疾病或心血管疾病的高预测风险. Intensified efforts to prevent progression to symptomatic cardiovascular disease and kidney failure may involve increasing or changing medications and an additional focus on lifestyle changes.

第四阶段——在这个阶段, 人们有心血管疾病的症状和多余的身体脂肪, 代谢危险因素或肾脏疾病. People may have already had a heart attack or stroke or may already have heart failure, 外周动脉疾病或心房颤动. Stage 4 is divided into subcategories for those with and without kidney failure.

The advisory suggests ways that professionals from different specialties can better work together, Ndumele说, 并强调了解决社会因素的重要性, 比如缺乏营养和锻炼的机会. 一个单独的 科学声明, also published in Circulation, spells out evidence for the approach outlined in the advisory.

The advisory also proposes updating the cardiovascular disease risk calculator to include measures of kidney function, 2型糖尿病控制与健康的社会决定因素.

当前计算器, 被称为集合队列方程, has been used since 2013 to help predict the risk of a heart attack or stroke in the next 10 years for people ages 40 to 75. The equation includes health and demographic factors about a person and is used to guide lifestyle recommendations and treatment decisions.

The advisory also suggests that the new risk tool be used in people as young as 30, 计算10年和30年的心血管风险, 并扩展到预测心力衰竭, 心脏不能有效泵血的情况.

该报告还呼吁对CKM进行系统性改革.

"There is a need for fundamental changes in how we educate health care professionals and the public, 我们如何组织护理以及如何报销CKM综合征相关的护理,恩杜梅尔说.