一半的心脏病发作可能是“隐性”的

 

心脏病已经成为国人的第一死因,值得关注。本文是关于心脏病的最新研究成果之一。...

Half of Heart Attacks Might Be 'Silent'
一半的心脏病发作可能是“隐性”的


MONDAY, May 16, 2016 (HealthDay News) -- As many as half of all heart attacks may be "silent" -- without the typical crushing chest pain, shortness of breath and cold sweats, new study findings suggest.

2016年5月16日,星期一(“健康日新闻”)——所有心脏病发作中,多达一半的可能属“隐性”——没有典型的让人受不了的胸痛、呼吸短促和冷汗,新的研究发现表明了这一点。

Among nearly 9,500 Americans included in the study, 45 percent of all heart attacks were silent, investigators found. And, the study authors said, these silent  heart attacks triple the odds of dying from heart disease.

研究者发现,在该项研究纳入的几乎9500美国人中,所有的心脏病发作,45%的属隐性。该研究的作者还说,这些隐性心脏病发作是死于心脏病几率的三倍。

"Silent heart attacks are almost as common as heart attacks with symptoms and just as bad," said senior study author Dr. Elsayed Soliman. He is director of the epidemiological cardiology research center at Wake Forest School of Medicine in Winston-Salem, N.C.

“隐性心脏病发作,几乎跟有症状的心脏病一样常见,且一样糟糕”,高级研究作者Elsayed Soliman说。他是位于北卡罗纳州温斯顿-塞勒姆的维克森林医学院的流行心脏病学研究中心主任。

Heart attacks reduce or stop blood flow to the heart muscle. Because silent heart attacks often go undiagnosed, people don't get the medical care needed to prevent another heart attack, or even death, the study authors explained.

心脏病发作会减少或阻止流向心肌的血流。该项研究的作者解释说:因为隐性心脏病发作通常诊断不出,人们没有获得防止另一次心脏病发作所需的医疗护理,有人甚至因此而死亡。

Symptoms of a silent heart attack are so mild they're barely noticed, if at all, Soliman said. Most are discovered accidentally, with damage showing up on an electrocardiogram (EKG) given during a regular exam or before surgery, he said.

一次隐性心脏病发作,其症状非常轻微,如果真发生了,几乎察觉不到,Soliman说。大多数是碰巧发现的,在一次例行检查或手术前检查中,心电图(EKG)上显示出了损伤,他说。

According to Dr. Suzanne Steinbaum, director of women's heart health at Lenox Hill Hospital in New York City, "When heart attacks are silent, people are less likely to get treatment. And that's been a problem with women. Symptoms are sometimes more subtle than the crushing chest pain."

照纽约城勒诺克斯山医院妇女心脏健康主任Suzanne Steinbaum博士的说法,“当心脏病隐性发作时,人们不太可能获得救治。对于妇女来说,这一直是个问题。相比难以忍受的胸痛,她们的症状有时比较微妙。”

Although silent heart attacks are more common among men, they are deadlier for women and perhaps black people, the study findings indicated.

该研究发现指出:尽管隐性心脏病发作在男性中更常见,但对于女人,或许还有黑人来说,它们更致命。

Steinbaum, who was not involved with the study, said that people should not dismiss symptoms such as fatigue, nausea or shortness of breath that occur when exercising or running errands but that go away when resting.

Steinbaum没有参与该研究,但他说:锻炼或跑腿中发生,而休息时就没有了的恶心或呼吸短促,对于这些症状,人们不应该不加理会。

"These subtle symptoms might be your heart and should not be ignored -- you should seek out a doctor's care," she said.

“这些微妙的症状可能表明你的心脏出事了,不应忽视——你应该去看一下医生”,她说。

"I tell all women that you need to take a close look at your risk factors for heart disease," Steinbaum added.

“我告诉所有的妇女,对她们说:对于心脏病方面的风险因素,你们应该睁大眼睛”,Steinbaum接着说。

A patient who has had a silent heart attack must be treated aggressively, Soliman said. Treatment includes controlling high blood pressure and cholesterol, and possibly modifying behavior.

有过一次隐性心脏病发作的患者,应积极治疗,Soliman说。疗法包括控制高血压和胆固醇,还可能要改正某些行为。

Lifestyle changes include eating healthier, exercising, losing weight and stopping smoking. It's the same prescription for heart attacks with and without symptoms, Soliman said.

生活方式的改变包括吃得更健康、锻炼、减重和戒烟。无论心脏病发作有无症状,都是这同一个处方,Soliman说。

Patients who have a little chest pain plus risk factors for heart attacks -- such as high blood pressure, obesity or diabetes-- should have an EKG "not only to see if they have had a heart attack, but also for prevention of outcomes that can happen later," he advised.

有轻微胸痛,还有心脏病发作风险因素——比如高血压、肥胖或糖尿病——的患者,应做一次心电图,这“不仅可以看出他们是否有过一次心脏病发作,还可以预防后续的发作”,他建议说。

Findings of a prior heart attack should not be taken lightly, Soliman added.

发现之前有过一次心脏病发作,就不应轻视,Soliman补充说。

For the study, Soliman and his colleagues collected data on middle-aged men and women who took part in a study assessing the causes and outcomes of hardening of the arteries. It was conducted in four U.S. communities.

对于该项研究,Soliman及同事收集了某些中年男人和女人的资料。这些人参与过一项在4个美国社区开展的评估动脉硬化起因与后果的研究。

Over roughly nine years of follow-up, 317 participants had silent heart attacks and 386 had heart attacks with classic symptoms. Deaths were tracked for more than 20 years.

经过大约9年的随访,317名参与者有过隐性心脏病发作,386人有过症状典型的心脏病发作。对他们的死亡情况,跟踪了20多年。

The researchers accounted for factors such as smoking, weight, diabetes, high blood pressure and cholesterol. They also took into account income and education, which could affect access to care.

研究者归纳的因素有:抽烟、超重、肥胖、高血压和胆固醇。他们还考虑了会影响就医的收入及教育因素。

The investigators found that risk of death from all causes increased 34 percent  after a silent heart attack.

研究者发现,在一次隐性心脏病发作后,所有起因导致的死亡风险提高了34%。

Dr. Andrew Freeman, director of clinical cardiology at National Jewish Health in Denver, said, "I don't think that people really understood the incidence of silent heart attack." Freeman is also a spokesman for the American College of Cardiology.

位于丹佛的全国犹太人健康中心的临床心脏病学主任Andrew Freeman博士说:“我认为,人们并没有真正明白隐性心脏病发作的发病率。”Freeman还是美国心脏病学会的发言人。

"In a country where the diet and exercise patterns are not ideal, there may be a lot of folks we may never comein contact with who may have this problem," he said.

“在一个饮食和锻炼方式都不理想的国家,或许有很多人,他们有这毛病,但我们一直没联系上”,他说。

Freeman suggested that doctors need to put more effort into prevention. "Doctors spend very little time talking to patients about diet and exercise," he said. "Every doctor visit should have some component of prevention."

Freeman建议,医生应投入更多精力到预防中。他说:“医生很少花时间跟病人谈饮食和锻炼。每次医生探视都应加入些预防知识。”

The report was published online May 16 in the journal Circulation.

该报告5月16日在线发表于《循环》期刊。


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