[在预防和治疗心房颤动中改变生活方式和控制风险因素]。

Humberto Rodríguez-Reyes, Enrique Asensio-Lafuente, Jorge E Cossío-Aranda, Gabriela Borrayo-Sánchez, Marco Alcocer-Gamba, Ana Berni-Betancourd, Eva M Picos-Bovio, Carlos F Gallegos-De Luna, César I Laguna-Muñoz, Víctor A Corona-Martínez, Luz M Muñoz-Gutiérrez, Karla M Rodríguez-Muñoz
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引用次数: 0

摘要

心房颤动(房颤)是最常见的心律失常,发病率、死亡率和费用都很高。尽管在预防栓塞事件和控制心律方面取得了相关进展,但在降低心房颤动的患病率、恶化程度和影响方面所做的工作却很少,因为心房颤动会随着年龄的增长以及酒精摄入、吸烟、压力等常见风险因素的增加而增加,还会与动脉高血压、糖尿病、心力衰竭、睡眠呼吸暂停、肾衰竭、慢性肺阻塞性疾病、缺血性心脏病和中风等重要合并症有关。幸运的是,新的证据表明,调整生活方式、充分控制风险因素和合并症可有效预防房颤的发生,尤其是阵发性房颤。因此,在控制心律或心率以及抗凝的同时,有必要采取一种多学科方法,将改变生活方式、控制风险因素和合并症结合起来。遗憾的是,在一般临床实践中,并没有考虑到这种整体方法策略,也很少对其进行研究或加以弱化。本报告的目的是1)回顾生活习惯、危险因素和疾病与房颤之间的关系;2)回顾可能导致房颤的每种情况的个体和共同生理病理机制;3)回顾控制生活习惯、危险因素和合并疾病对房颤控制和影响的影响;4)为启动多学科综合房颤治疗提供指南和建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Lifestyle modification and risk factor control in the prevention and treatment of atrial fibrillation].

Atrial fibrillation (AF) is the most prevalent arrhythmia and is related with significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact, since it increases with ageing as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal presentations. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control, is necessary in conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement's objectives are to: 1) review the relationship between habits, risk factors and illnesses with AF, 2) review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, 3) review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, and 4) supply guidelines and recommendations to start multidisciplinary and integrative AF treatment.

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