生命早期心血管危险因素与成年期心血管疾病风险

Early-life cardiovascular risk factors and cardiovascular disease risk in adulthood

摘要

心血管疾病的发生发展具有明显的生命历程特征。越来越多的长期队列研究表明,儿童青少年时期的超重和肥胖、血压升高、血脂异常、糖代谢异常、烟草暴露、体力活动不足及不健康膳食等危险因素,可持续存在或追踪至成年期,并与亚临床动脉粥样硬化、动脉僵硬、心脏和肾脏靶器官损害以及临床心血管事件相关。儿童期多危险因素聚集所形成的长期累积暴露,较单一指标异常更能反映成年期心血管风险。与此同时,体重、血压及血脂等异常若至成年期得到改善,远期风险可明显降低,提示儿童期仍是具有较强可塑性的关键干预窗口。本文结合国际儿童心血管队列及我国汉中儿童高血压研究队列的证据,系统梳理儿童期主要心血管危险因素与成年期心血管疾病风险的关系,并提出以综合风险筛查、家庭-学校-社区协同干预、连续随访及全生命周期管理为核心的防控建议。

Abstract

Cardiovascular disease develops across the life course. Growing evidence from long-term cohort studies indicates that overweight and obesity, elevated blood pressure, dyslipidemia, abnormal glucose metabolism, tobacco exposure, physical inactivity, and unhealthy dietary patterns during childhood and adolescence may persist or track into adulthood and are associated with subclinical atherosclerosis, arterial stiffness, cardiac and renal target-organ damage, and clinical cardiovascular events. The clustering of multiple risk factors in childhood and the resulting cumulative burden over time may better characterize later cardiovascular risk than abnormalities in any single risk factor. Importantly, improvements in weight status, blood pressure, and lipid profiles by adulthood are associated with substantially lower long-term risk, highlighting childhood as a critical window for prevention. Drawing on evidence from major international cardiovascular cohorts beginning in childhood and the Hanzhong Adolescent Hypertension Cohort, this article systematically reviews the associations between major childhood cardiovascular risk factors and cardiovascular disease risk in adulthood and offers recommendations for prevention and control, emphasizing comprehensive risk screening, coordinated family-school-community interventions, continuous follow-up, and cardiovascular health management across the life course.

关键词

儿童期 / 心血管危险因素 / 心血管疾病 / 生命历程 / 预防

Key words

childhood / cardiovascular risk factors / cardiovascular disease / life course / prevention

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基金资助

陕西省重点研发计划一般项目(2025SF-YBXM-185)