随着我国经济快速发展和人民生活水平的提高，急性心肌梗死的发病率与死亡率逐年升高。秋冬季更是心血管疾病的高发期，气温的下降不仅带来了寒 冷，也增加了心梗的发生风险。 审核专家：中国医学科学院阜外医院心内科副主任医师 安涛 刚垫,机云山巩仪化。 2人 武好医生 小时： 好： 典型症状 前胸剧烈疼痛,呈现压榨性、 闷痛或紧缩感,持续时间超过 15分钟,经休息和含服硝酸甘 油无效。 2.胸部压迫感( 像有块大石头压在胸口,感觉 闷、堵、胀痛,可能持续几分钟 或反复出现。 不典型症状 l.放射性疼痛( 胸部疼痛扩散到左肩、手臂 部、下颌或牙床,表现为 或酸痛。女性患者更易出 种不典型症状。 2.头晕乏力 ( 突然乏力虚弱,全身发 冷，头昏脑胀甚至晕倒昏 l.剧烈胸痛 ( 3.消化道不适 : FEE | FEATS ttp://www.f 3.伴随症状( 常伴有大汗淋漓、面色苍白、 呼吸困难、恶心呕吐、头晕甚 e量厥。 上腹疼痛、恶心、胃灼热 吐,容易与胃肠疾病混淆。 4.糖尿病患者 可能无痛，仅表现为气短， 如果发现自己出现了这些症状,切勿疏忽大意, 保持冷静,及时采取自救措施并立即就医。 9人的医生 all his ...

Core Points - The article discusses the increasing incidence of strokes among young people and identifies four main factors contributing to this trend [1] - It emphasizes the importance of early detection and management of risk factors to prevent strokes [2] Group 1: Factors Contributing to Strokes in Young People - Many young individuals neglect regular health check-ups, leading to undiagnosed conditions such as diabetes, hypertension, and hyperlipidemia, which can result in strokes [1] - Lifestyle choices, including late-night activities and lack of exercise, contribute to obesity and atherosclerosis, increasing the risk of stroke [1] - Cardiac issues, particularly atrial fibrillation or congenital heart diseases, can lead to blood clots that may block cerebral blood vessels, causing strokes [1] - Systemic diseases, such as autoimmune disorders, blood diseases, or arteritis, can also increase the likelihood of strokes in younger populations [1] - Specific risk factors for women include long-term use of contraceptives and smoking, which elevate stroke risk [1] Group 2: Early Detection and Prevention - The article highlights the "120 mnemonic" for early detection of stroke symptoms: - "1" refers to checking for facial symmetry and any drooping [2] - "2" involves assessing for weakness or numbness in one side of the body [2] - "0" indicates checking for difficulties in speech or understanding language [2] - Immediate action, such as calling emergency services (120) and seeking treatment at a specialized stroke center, is crucial upon noticing these warning signs [2]

Core Viewpoint - The article highlights the increasing risk of cardiovascular diseases (CVD) during the autumn and winter seasons, particularly among vulnerable populations such as the elderly and those with pre-existing health conditions. It emphasizes the importance of awareness regarding early symptoms and preventive measures to mitigate risks associated with cold weather and lifestyle factors. Group 1: Cardiovascular Disease Statistics - In 2021, CVD was the leading cause of death among urban and rural residents in China, accounting for 48.98% and 47.35% of deaths respectively [3] - The crude incidence rate of CVD among residents aged 18 and above in 2023 was 620.33 per 100,000, with males at 717.36 and females at 519.64, showing a significant increase with age [3] Group 2: Seasonal Impact on Cardiovascular Health - Cold weather poses a direct challenge to blood vessels, leading to constriction and increased blood pressure, which heightens the heart's workload [4] - The autumn and winter seasons coincide with a rise in respiratory infections, which can indirectly harm the cardiovascular system and increase the risk of acute myocardial infarction [6] Group 3: High-Risk Populations - Elderly individuals and young professionals under high stress are identified as high-risk groups for cardiovascular events during the colder months [6][9] - Lifestyle factors such as obesity, hypertension, and sedentary behavior contribute to the increasing prevalence of CVD among younger populations [9] Group 4: Early Symptoms and Misdiagnosis - Common early symptoms of cardiovascular issues include fatigue, chest discomfort, palpitations, and sleep disturbances, which are often overlooked or misdiagnosed as gastrointestinal problems [7] - Patients frequently visit other medical departments without receiving appropriate cardiovascular care, highlighting the need for better awareness and education [8] Group 5: Preventive Measures and Lifestyle Recommendations - Maintaining a healthy lifestyle, including a balanced diet low in salt and high in fruits and vegetables, is crucial for preventing cardiovascular diseases [10] - Regular physical activity, stress management, and adequate sleep are essential components of cardiovascular health [11] - During cold weather, individuals are advised to dress warmly and engage in moderate exercise to adapt to temperature changes [11]

Core Insights - The article emphasizes the increasing prevalence of dyslipidemia among adults in China, with a reported rate of 35.6% in individuals aged 18 and above as of 2018, highlighting the need for early intervention in blood lipid management [6][8]. Summary by Sections Dyslipidemia Prevalence - Dyslipidemia includes conditions such as hypercholesterolemia, hypertriglyceridemia, mixed dyslipidemia, and low high-density lipoprotein cholesterol [6]. - The article points out that dyslipidemia often has no early symptoms, yet it can lead to significant vascular damage over time, increasing the risk of atherosclerotic cardiovascular diseases [6]. Importance of Early Intervention - Recent research published in *Nature* suggests that the prevention of atherosclerosis should begin earlier in life, particularly focusing on blood lipid management in children and adolescents [6][8]. - The study conducted by the University of Cambridge indicates that intermittent high-fat diets from a young age significantly increase the risk of atherosclerosis compared to those who only consume high-fat diets later in life [8][9]. Research Findings - The findings from the "Young Finnish Cardiovascular Risk Study" show that individuals with elevated cholesterol levels in childhood have more severe atherosclerotic plaques in adulthood [8][9]. - The research indicates that early cholesterol elevation is closely linked to the incidence and severity of carotid atherosclerosis in middle age [9]. Mechanisms of Atherosclerosis - The study suggests that macrophages, which normally help clear damaged cells and cholesterol, have their gene expression altered by early cholesterol elevation, reducing their protective function [9]. - Intermittent cholesterol elevation, often due to fluctuating dietary habits, may lead to greater damage and increased heart disease risk, particularly in patients who do not adhere to medication regimens [9][11]. Additional Research - A concurrent study from Paris Descartes University also found that intermittent high-fat diets accelerate atherosclerosis more than continuous high-fat diets, indicating a need for consistent dietary management [11].

Core Insights - The article emphasizes the increasing prevalence of dyslipidemia among adults in China, with a reported rate of 35.6% in individuals aged 18 and above as of 2018, highlighting the need for early intervention in blood lipid management [6][8]. Group 1: Health Risks and Findings - Dyslipidemia often presents no early symptoms, yet it can lead to significant vascular damage over time, increasing the risk of atherosclerotic cardiovascular diseases [6]. - Recent research suggests that the prevention of atherosclerosis should begin earlier in life, particularly focusing on the dietary habits of children and adolescents [6][9]. - A study conducted by Cambridge University found that young mice exposed to intermittent high-fat diets exhibited a significantly higher risk of atherosclerosis compared to those that were only exposed in later life [8][9]. Group 2: Research Implications - The findings indicate a strong correlation between elevated cholesterol levels in early life and the severity of atherosclerotic plaques in middle age [9]. - The research identified that early cholesterol elevation alters the gene expression of macrophages, which are crucial for clearing damaged cells and cholesterol, thereby weakening their protective function [9]. - Intermittent spikes in cholesterol levels, often due to dietary fluctuations, may pose greater risks than sustained high cholesterol, as seen in patients who irregularly take statins [9][11]. Group 3: Additional Studies - A concurrent study from Paris University also confirmed that intermittent high-fat diets accelerate atherosclerosis more than continuous high-fat diets, indicating a need for consistent dietary management [11].

Core Viewpoint - Gouty arthritis is a common disease closely related to dietary habits, with a higher prevalence in males and a trend towards younger patients [1] Group 1: Disease Overview - Gouty arthritis is characterized by high uric acid levels leading to joint inflammation, commonly affecting males and often starting suddenly with severe pain [5][7] - Symptoms typically peak within 12 hours and may resolve within days or weeks, with over 50% of initial cases occurring in the first metatarsophalangeal joint [5] Group 2: Risk Factors - Key risk factors for gout include excessive alcohol consumption, high-purine diets, and lack of sleep, with sugary drinks particularly harmful for children [5] - Chronic conditions such as chronic gouty nephropathy can arise from uric acid deposits in the kidneys, and high uric acid levels may accelerate atherosclerosis, increasing cardiovascular disease risk [7] Group 3: Prevention and Treatment - Prevention strategies include dietary control, limiting seafood intake, ensuring daily water intake exceeds 2000 milliliters, and avoiding triggers like late nights and intense exercise [9] - During acute attacks, treatment focuses on anti-inflammatory and pain relief methods, while recurrent cases may require long-term uric acid-lowering therapy [9]

Core Insights - The article highlights the increasing prevalence of coronary heart disease (CHD) in China, particularly among younger individuals, driven by unhealthy lifestyle choices and societal pressures [1][2][3]. Group 1: Prevalence and Trends - Coronary heart disease patients in China have exceeded 11 million, growing at an annual rate of approximately 2.5% [1]. - There is a concerning trend of younger individuals being diagnosed with CHD, attributed to unhealthy lifestyles and various environmental and psychological factors [1][2][3]. Group 2: Lifestyle Factors - Unhealthy lifestyle choices, such as a Westernized diet high in calories, fats, and sugars, along with reduced physical activity, are significant contributors to the rising rates of CHD among the youth [2][3]. - Factors like prolonged sitting, lack of exercise, sleep deprivation, and high stress levels further exacerbate the risk of developing cardiovascular diseases [3][4]. Group 3: Prevention and Management - Emphasis is placed on preventive measures for individuals under 35, including adopting healthy habits, regular health check-ups, and maintaining a balanced diet [2][4]. - Key recommendations for prevention include low-salt and low-fat diets, regular exercise, weight management, and stress control [2][4][5]. Group 4: Treatment Approaches - Drug therapy is considered the cornerstone of CHD treatment, aimed at alleviating symptoms, slowing plaque progression, and preventing thrombosis [7][8]. - Surgical options include percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), with the choice depending on the severity and extent of the disease [7][9]. Group 5: Advances in Treatment - New drug developments, such as PCSK9 inhibitors, show promise in significantly lowering lipid levels and improving patient outcomes compared to traditional statins [8][9]. - The integration of advanced technologies, including AI and imaging techniques, is enhancing the precision of CHD diagnosis and treatment [9].

Core Insights - Atherosclerosis is increasingly affecting younger adults in their 30s and 40s, not just the elderly, necessitating serious attention to this health issue [1] Group 1: Types of Affected Arteries - The carotid artery, which connects directly to the brain, is prone to plaque buildup, typically starting around age 40, with significant prevalence by age 60 [2] - The coronary arteries are critical as plaque accumulation can lead to coronary heart disease, with most acute myocardial infarctions resulting from ruptured plaques [3] - Peripheral arteries, which supply blood to the lower limbs, can become narrowed or blocked, leading to symptoms like pain and numbness, especially during physical activity [4] - Atherosclerosis in the aorta is more common in men over 40, characterized by reduced elasticity and potential aneurysm formation [5] - Renal artery atherosclerosis can lead to insufficient kidney perfusion, often presenting with fatigue and increased nighttime urination as the disease progresses [6] Group 2: Diagnostic Insights - Carotid artery plaque checks are common due to the superficial location of the carotid artery, making it easier to assess via ultrasound, although any plaque presence is concerning [7] - The stability of plaques is more critical than their size; unstable, soft plaques pose a greater risk of rupture, similar to a thin-skinned dumpling that can easily break [7]

Core Viewpoint - There is a compelling link between gut microbiota and atherosclerosis, a disease characterized by cholesterol and inflammatory cell deposits in arterial walls, leading to potential health issues like stroke and heart attacks [1][5]. Group 1: Research Findings - A study published in Nature identified Imidazole Propionate (ImP), a metabolite produced by gut bacteria, as a driver of atherosclerosis, suggesting new targets for early detection and personalized treatment of cardiovascular diseases [2][10]. - The study highlights the necessity for early intervention in seemingly healthy populations due to rising morbidity and mortality rates associated with cardiovascular diseases [5]. - The research team found a strong correlation between ImP levels and the severity of atherosclerosis in both mouse models and human cohorts [7][10]. Group 2: Mechanism of Action - ImP promotes atherosclerosis through the activation of the imidazoline-1 receptor (I1R) in myeloid cells, indicating a specific signaling pathway that could be targeted for therapeutic purposes [8][10]. - Blocking the ImP-I1R signaling axis can inhibit the development of atherosclerosis induced by either ImP or a high-cholesterol diet, suggesting a potential intervention strategy [8][10]. Group 3: Implications for Treatment - The findings open new avenues for the early diagnosis and personalized treatment of atherosclerosis, emphasizing the importance of understanding gut microbiota's role in cardiovascular health [10].

Core Points - The article discusses the development and significance of blood vessels in the human body, highlighting their role in transporting oxygen and nutrients, and the impact of modern lifestyle choices on vascular health [4][6][40] Group 1: Blood Vessel Development and Function - Blood vessels begin to grow from the first month of embryonic development, reaching a total length of approximately 100,000 kilometers in adults, which is enough to circle the Earth's equator two and a half times [2][4] - They serve as the body's highways for transporting essential materials, including oxygen and nutrients, to all tissues and organs [4] Group 2: Impact of Lifestyle on Vascular Health - Aging leads to the natural hardening and aging of blood vessels, which can result in various cardiovascular diseases [6] - Modern lifestyle habits, particularly late-night activities and sedentary behavior, are causing vascular aging to occur earlier in younger populations [8][10] Group 3: Consequences of Poor Lifestyle Choices - Night owls often experience increased blood pressure due to the secretion of adrenaline and noradrenaline, which accelerates heart rate and blood flow [10] - Sedentary habits combined with late-night activities can lead to blood clots due to sluggish blood flow and increased blood viscosity [12][18] Group 4: Health Risks Associated with Vascular Issues - Long-term effects of poor lifestyle choices can lead to the formation of larger blood clots and serious health consequences, including acute embolism [29][35][39] - A significant percentage of global deaths are attributed to thrombotic diseases, surpassing those caused by cancer and infectious diseases [39][40]