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[AHA2010]有效降低危险因素,促进心血管健康——K. C. Ferdinand教授专访

作者:  K.C.Ferdinand教授   日期:2010/11/17 15:18:01

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当前公共卫生领域很重视社区健康促进和疾病预防。我们应如何改进社区健康促进和疾病预防的手段?


  <International Circulation>:  In addressing a Chinese audience, many of those points you have made are certainly part of the Chinese lifestyle. What would be your recommendations for actually implementing those?

      《国际循环》:就我们中国来说,您所提到的肯定已经是中国人生活方式的一部分了,那么您认为我们如果才能真正实现生活方式的改变呢?

  Dr Ferdinand: I believe the amount of salt in processed food is one of the first steps the Chinese population can embrace. I have been to China and have been to some rural areas and a lot of their food is prepared with a high salt intake. While the Chinese, and even the Japanese, have lower rates of coronary heart disease related to atherosclerosis, the rates of hypertension are actually somewhat high, and the rates of stroke are disproportionate. Stroke and hypertension can be better predicted by salt levels in food. A lot of that is acculturated taste meaning that a person gets used to eating a lot of sodium. If the population learns how to prepare food with less sodium, the food does become more palatable after a while and the person can adjust their food intake with lower processed sodium. Beyond the food, smoking needs to be addressed. Clearly the rate of smoking in China is higher than that in the United States because the United States has recognized that smoking is the number one preventable cause of heart disease. Preventable means that if you don’t smoke, it’s a risk factor you don’t have. It is even more difficult to change the amount of sodium and fats in our food than it is to change smoking habits. If you stop smoking then you completely remove that risk factor as the risk of smoking returns to baseline in about three to four years. It is something that can be changed. It can affect heart disease rates and it can be changed quite quickly. It also affects peripheral arterial disease which is disease showing signs in the legs and that is also increased with smoking. There are a lot of reasons not to smoke, in addition to certain cancers (lung cancer, cancers of the nasopharanyx, mouth and throat), but heart disease is one of the main ones.

        Ferdinand博士:我相信对中国人群来说采取的第一个措施应该是在加工食品中限盐。我去过中国,也走访过中国农村,在那里很多方便食品含盐量非常高。尽管中国人(日本人也一样)的动脉粥样硬化性冠心病的发病率比较低,但高血压的患病率的确很高,这导致脑卒中的发病率与冠心病不成比例。而高血压和脑卒中都是可以由食物中盐的水平来预测的。这种情况很多时候是与文化相适应的口味造成的,人们已经习惯吃很咸的食物了。应该让老百姓知道怎样用更少的盐合理烹调食物,把食物做得更加美味的同时,使食盐摄入量得到相应降低。除了食物外,吸烟也值得一提。中国的吸烟率高于美国,因为美国目前已经把吸烟看作是引起心脏病的第一位原因。吸烟的习惯是可以改变的,你不吸烟就意味着你没有这个危险因素(但我认为,减少食物中的含盐量比改变吸烟习惯更难)。如果你真的戒烟了,那么3~4年以后,吸烟所致的危险水平就可以重新回到基线水平。就是这样的一点点改变,就可以使心脏病的发病率迅速降低。吸烟同样可以使外周动脉疾病(一般在腿上出现症状)的发病率增加。不要吸烟的原因有很多,除了肿瘤(如,肺癌、鼻咽癌、口腔癌和喉癌)以外,心脏病是最主要的原因。

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社区健康促进生活方式健康教育防治指南K. C. Ferdinand教授

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