动脉粥样硬化性心血管疾病和衰弱的研究进展与临床启示
Research Advances and Clinical Implications of Atherosclerotic Cardiovascular Diseases and Frailty
DOI: 10.12677/acm.2025.151130, PDF,   
作者: 陈 偲, 王 丽*:重庆医科大学附属第二医院老年医学科,重庆
关键词: 衰弱心血管疾病动脉硬化衰老衰弱评估Frailty Cardiovascular Diseases Arteriosclerosis Aging Frailty Assessment
摘要: 伴随全球人口老龄化进程的加速,衰弱与动脉粥样硬化性心血管疾病(ASCVD)的发病率呈现出明显的上升趋势,二者之间存在着错综复杂的双向关联,并且共享着许多相同的危险因素以及潜在的生物学机制。衰弱已被明确认定为心血管疾病患者极为关键的独立预后指标,它不仅深刻影响着心血管疾病的一级和二级预防策略的制定与实施,同时也对这些患者能否顺利被纳入关键临床试验以及接受高级心脏干预措施等构成了实质性的障碍。在当今的医学领域,动脉粥样硬化性心血管疾病与衰弱已然成为备受瞩目的两大健康焦点问题。本文通过检索相关国内外文献,对衰弱与ASCVD的相关研究做一综述。
Abstract: With the acceleration of the global population aging process, the incidences of frailty and atherosclerotic cardiovascular disease (ASCVD) have shown a significant upward trend. There exists a complex bidirectional relationship between them, sharing numerous common risk factors and underlying biological mechanisms. Frailty has been clearly identified as a crucial independent prognostic indicator for patients with cardiovascular diseases. It not only profoundly influences the formulation and implementation of primary and secondary prevention strategies for cardiovascular diseases but also poses a substantial obstacle to the inclusion of these patients in key clinical trials and their access to advanced cardiac intervention measures. In the current medical field, atherosclerotic cardiovascular disease and frailty have become two prominent health focus issues. By extensively retrieving relevant domestic and foreign literature, this article comprehensively and systematically reviews the latest research findings on frailty and ASCVD.
文章引用:陈偲, 王丽. 动脉粥样硬化性心血管疾病和衰弱的研究进展与临床启示[J]. 临床医学进展, 2025, 15(1): 974-980. https://doi.org/10.12677/acm.2025.151130

参考文献

[1] 中华人民共和国民政部. 2021年民政事业发展统计公报[EB/OL].
https://www.mca.gov.cn/images3/www2017/file/202208/2021mzsyfztjgb.pdf, 2024-11-04.
[2] 胡盛寿, 王增武. 《中国心血管健康与疾病报告2022》概述[J]. 中国心血管病研究, 2023, 21(7): 577-600.
[3] Fried, L.P., Tangen, C.M., Walston, J., Newman, A.B., Hirsch, C., Gottdiener, J., et al. (2001) Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M146-M157. [Google Scholar] [CrossRef] [PubMed]
[4] Morley, J.E., Vellas, B., Abellan van Kan, G., Anker, S.D., Bauer, J.M., Bernabei, R., et al. (2013) Frailty Consensus: A Call to Action. Journal of the American Medical Directors Association, 14, 392-397. [Google Scholar] [CrossRef] [PubMed]
[5] 中华医学会老年医学分会. 老年患者衰弱评估与干预中国专家共识[J]. 中华老年医学杂志, 2017, 36(3): 251-256.
[6] Vetrano, D.L., Palmer, K., Marengoni, A., Marzetti, E., Lattanzio, F., Roller-Wirnsberger, R., et al. (2018) Frailty and Multimorbidity: A Systematic Review and Meta-Analysis. The Journals of Gerontology: Series A, 74, 659-666. [Google Scholar] [CrossRef] [PubMed]
[7] Cesari, M., Pérez-Zepeda, M.U. and Marzetti, E. (2017) Frailty and Multimorbidity: Different Ways of Thinking about Geriatrics. Journal of the American Medical Directors Association, 18, 361-364. [Google Scholar] [CrossRef] [PubMed]
[8] Apóstolo, J., Cooke, R., Bobrowicz-Campos, E., Santana, S., Marcucci, M., Cano, A., et al. (2017) Predicting Risk and Outcomes for Frail Older Adults: An Umbrella Review of Frailty Screening Tools. JBI Database of Systematic Reviews and Implementation Reports, 15, 1154-1208. [Google Scholar] [CrossRef] [PubMed]
[9] Dent, E., Kowal, P. and Hoogendijk, E.O. (2016) Frailty Measurement in Research and Clinical Practice: A Review. European Journal of Internal Medicine, 31, 3-10. [Google Scholar] [CrossRef] [PubMed]
[10] Veronese, N., Cereda, E., Stubbs, B., Solmi, M., Luchini, C., Manzato, E., et al. (2017) Risk of Cardiovascular Disease Morbidity and Mortality in Frail and Pre-Frail Older Adults: Results from a Meta-Analysis and Exploratory Meta-Regression Analysis. Ageing Research Reviews, 35, 63-73. [Google Scholar] [CrossRef] [PubMed]
[11] Morley, J.E., Malmstrom, T.K. and Miller, D.K. (2012) A Simple Frailty Questionnaire (FRAIL) Predicts Outcomes in Middle Aged African Americans. The Journal of Nutrition, Health and Aging, 16, 601-608. [Google Scholar] [CrossRef] [PubMed]
[12] 盛莉, 王晓娜, 肖文凯, 等. 老年心血管疾病合并衰弱评估与管理中国专家共识[J]. 中华老年多器官疾病杂志, 2023, 22(7): 481-491.
[13] Mitnitski, A.B., Mogilner, A.J., MacKnight, C. and Rockwood, K. (2002) The Accumulation of Deficits with Age and Possible Invariants of Aging. The Scientific World JOURNAL, 2, 1816-1822. [Google Scholar] [CrossRef] [PubMed]
[14] Rockwood, K. and Mitnitski, A. (2007) Frailty in Relation to the Accumulation of Deficits. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 722-727. [Google Scholar] [CrossRef] [PubMed]
[15] Rockwood, K. (2005) A Global Clinical Measure of Fitness and Frailty in Elderly People. Canadian Medical Association Journal, 173, 489-495. [Google Scholar] [CrossRef] [PubMed]
[16] 符琳琳, 王青, 张少景, 等. 四种衰弱评估工具对老年住院患者出院后全因死亡预测效果比较[J]. 中华老年多器官疾病杂志, 2020, 19(9): 651-655.
[17] Buta, B.J., Walston, J.D., Godino, J.G., Park, M., Kalyani, R.R., Xue, Q., et al. (2016) Frailty Assessment Instruments: Systematic Characterization of the Uses and Contexts of Highly-Cited Instruments. Ageing Research Reviews, 26, 53-61. [Google Scholar] [CrossRef] [PubMed]
[18] Rolfson, D.B., Majumdar, S.R., Tsuyuki, R.T., Tahir, A. and Rockwood, K. (2006) Validity and Reliability of the Edmonton Frail Scale. Age and Ageing, 35, 526-529. [Google Scholar] [CrossRef] [PubMed]
[19] Ensrud, K.E. (2008) Comparison of 2 Frailty Indexes for Prediction of Falls, Disability, Fractures, and Death in Older Women. Archives of Internal Medicine, 168, 382-389. [Google Scholar] [CrossRef] [PubMed]
[20] Cesari, M., Gambassi, G., Abellan van Kan, G. and Vellas, B. (2013) The Frailty Phenotype and the Frailty Index: Different Instruments for Different Purposes. Age and Ageing, 43, 10-12. [Google Scholar] [CrossRef] [PubMed]
[21] López-Otín, C., Blasco, M.A., Partridge, L., Serrano, M. and Kroemer, G. (2023) Hallmarks of Aging: An Expanding Universe. Cell, 186, 243-278. [Google Scholar] [CrossRef] [PubMed]
[22] Xu, Y., Wang, M., Chen, D., Jiang, X. and Xiong, Z. (2022) Inflammatory Biomarkers in Older Adults with Frailty: A Systematic Review and Meta-Analysis of Cross-Sectional Studies. Aging Clinical and Experimental Research, 34, 971-987. [Google Scholar] [CrossRef] [PubMed]
[23] Qu, T., Yang, H., Walston, J.D., Fedarko, N.S. and Leng, S.X. (2009) Upregulated Monocytic Expression of CXC Chemokine Ligand 10 (CXCL-10) and Its Relationship with Serum Interleukin-6 Levels in the Syndrome of Frailty. Cytokine, 46, 319-324. [Google Scholar] [CrossRef] [PubMed]
[24] Cesari, M., Penninx, B.W., Newman, A.B., Kritchevsky, S.B., Nicklas, B.J., Sutton-Tyrrell, K., Rubin, S.M., Ding, J., Simonsick, E.M., Harris, T.B. and Pahor, M. (2003) Inflammatory Markers and Onset of Cardiovascular Events: Results from the Health ABC Study. Circulation, 108, 2317-2322. [Google Scholar] [CrossRef
[25] Cesari, M., Penninx, B.W.J.H., Pahor, M., Lauretani, F., Corsi, A.M., Williams, G.R., et al. (2004) Inflammatory Markers and Physical Performance in Older Persons: The InCHIANTI Study. The Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 59, M242-M248. [Google Scholar] [CrossRef] [PubMed]
[26] Emerging Risk Factors Collaboration, Kaptoge, S., Di Angelantonio, E., Lowe, G., Pepys, M.B., Thompson, S.G., Collins, R. and Danesh, J. (2010) C-Reactive Protein Concentration and Risk of Coronary Heart Disease, Stroke, and Mortality: An Individual Participant Meta-Analysis. The Lancet (London, England), 375, 132-140.
[27] Stepanova, M., Rodriguez, E., Birerdinc, A. and Baranova, A. (2015) Age-Independent Rise of Inflammatory Scores May Contribute to Accelerated Aging in Multi-Morbidity. Oncotarget, 6, 1414-1421. [Google Scholar] [CrossRef] [PubMed]
[28] Liberale, L., Montecucco, F., Tardif, J., Libby, P. and Camici, G.G. (2020) Inflammageing: The Role of Inflammation in Age-Dependent Cardiovascular Disease. European Heart Journal, 41, 2974-2982. [Google Scholar] [CrossRef] [PubMed]
[29] Soysal, P., Isik, A.T., Carvalho, A.F., Fernandes, B.S., Solmi, M., Schofield, P., et al. (2017) Oxidative Stress and Frailty: A Systematic Review and Synthesis of the Best Evidence. Maturitas, 99, 66-72. [Google Scholar] [CrossRef] [PubMed]
[30] Salisbury, D. and Bronas, U. (2015) Reactive Oxygen and Nitrogen Species: Impact on Endothelial Dysfunction. Nursing Research, 64, 53-66. [Google Scholar] [CrossRef] [PubMed]
[31] Brinkley, T.E., Nicklas, B.J., Kanaya, A.M., Satterfield, S., Lakatta, E.G., Simonsick, E.M., et al. (2009) Plasma Oxidized Low-Density Lipoprotein Levels and Arterial Stiffness in Older Adults: The Health, Aging, and Body Composition Study. Hypertension, 53, 846-852. [Google Scholar] [CrossRef] [PubMed]
[32] Jiang, X., Xu, X., Ding, L., Lu, J., Zhu, H., Zhao, K., et al. (2022) The Association between Metabolic Syndrome and Presence of Frailty: A Systematic Review and Meta-Analysis. European Geriatric Medicine, 13, 1047-1056. [Google Scholar] [CrossRef] [PubMed]
[33] Shakya, S., Bajracharya, R., Ledbetter, L. and Cary, M.P. (2022) The Association between Cardiometabolic Risk Factors and Frailty in Older Adults: A Systematic Review. Innovation in Aging, 6, igac032. [Google Scholar] [CrossRef] [PubMed]
[34] Ijaz, N., Buta, B., Xue, Q., Mohess, D.T., Bushan, A., Tran, H., et al. (2022) Interventions for Frailty among Older Adults with Cardiovascular Disease: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 79, 482-503. [Google Scholar] [CrossRef] [PubMed]
[35] Damluji, A.A., Ijaz, N., Chung, S., Xue, Q., Hasan, R.K., Batchelor, W.B., et al. (2023) Hierarchical Development of Physical Frailty and Cognitive Impairment and Their Association with Incident Cardiovascular Disease. JACC: Advances, 2, Article ID: 100318. [Google Scholar] [CrossRef] [PubMed]
[36] Damluji, A.A. and Cohen, M.G. (2022) The Influence of Frailty on Cardiovascular Disease: The Time for a “Frailty Academic Research Consortium” Is Now! Circulation: Cardiovascular Interventions, 15, e011669. [Google Scholar] [CrossRef] [PubMed]