心脏病治疗的最新前沿消息

There have been few new transformative cardiovascular treatments since the mid-1980s to early 1990s, when a stream of large-scale trials of new agents ranging from clot-busters to treat heart attacks to the mega class of statins electrified the cardiology field with evidence of significant improvements in survival from the disease. One reason: Some of those remedies have proven tough to beat with new treatments.
从1980年代中期到1990年代初期，治疗心血管疾病的方法就没有多少新的改变（自那以后，对治疗心脏病发作的溶血剂和大量降低胆固醇的他汀类药物等新药进行的一系列大规模试验证明患心脏病的生存几率可以大大提高，这让心脏病学界兴奋不已）。其中一个原因是：那些疗法中有些被证明很难被新的治疗手段所超越。

What's more, use of the current menu of medicines for reducing heart risk remains an imprecise art. Besides blood pressure drugs, cholesterol-lowering statins also are widely prescribed. Drug-trial statistics show that to prevent a single first heart attack in otherwise healthy patients can require prescribing a statin to scores of patients, but no one knows for sure who actually benefits and who doesn't.
此外，使用现行的药物目录来降低心脏病风险还是一件没有把握的事情。除了降血压的药物之外，处方里大量出现的还有降低胆固醇的他汀类药物。药物试验统计数字表明，为了防止在其它方面十分健康的病人出现第一次心脏病发作，数十位病人可能都会被开据他汀类药物的处方，但是没人确切知道这药对谁真正有用，对谁没有作用。

'It would be great if we could make some more paradigm-shifting discoveries,' said Michael Lauer, director of cardiovascular sciences at the NHLBI, which is a part of the National Institutes of Health.
美国国家卫生研究院下属 NHLBI的心血管学科主任迈克尔・劳尔(Michael Lauer)说：“如果我们能够在转变思维模式方面做出更多发现的话，那就太好了。”

Finding new treatments isn't the only aim of the new project. 'You could use existing therapies smarter,' said Joseph Loscalzo, chairman of medicine at Brigham and Women's Hospital in Boston.
找到新的治疗方法并不是新研究项目的唯一目的。波士顿布里格姆妇科医院(Brigham and Women's Hospital)的医务委员会主席约瑟夫・洛斯卡尔佐(Joseph Loscalzo)说：“你可以更高明地使用现存的疗法。”

The American Heart Association launched the initiative and has committed $30 million to it over the next five years. The AHA sees the project as critical to its goal to achieve a 20% improvement in cardiovascular health in the U.S. while also reducing deaths from heart disease and stroke by 20% for the decade ending in 2020, said Nancy Brown, the noNPRofit organization's chief executive.
美国心脏病学会(The American Heart Association,简称AHA)发起了本次研究行动，并答应在今后的五年中拨付3,000万美元（约合人民币1.83亿元）的资金。AHA打算在2020年之前的十年时间里将美国的心血管健康水平提升20%，同时将心脏病和中风引起的死亡病例减少20%，它把本项目看成是实现目标的关键。

The Jackson study has already identified characteristics of cardiovascular risk among African-American patients 'that may have promise for new insights' in a collaborative effort, said Adolfo Correa, professor of medicine and pediatrics at University of Mississippi Medical Center and interim director of the Jackson study.
密西西比大学医学中心(Mississippi Medical Center)的医学及儿科学教授、杰克逊研究项目的临时主管阿道夫・科雷亚(Adolfo Correa)说，杰克逊研究已经找到了非洲裔美国人心血管疾病患病危险的特征，这在合作项目中“也许有望让人获得新的认识”。

For instance, there is a higher prevalence of obesity among Jackson participants than seen in the Framingham cohorts. Obesity is associated with high blood pressure, diabetes and cardiovascular risk. Diabetes is also more prevalent among blacks than whites.
比如，杰克逊研究的参与者中肥胖者所占比例比弗雷明汉研究队伍中的人高。肥胖与高血压、糖尿病和心血管疾病危险有关。黑人中患糖尿病的人也比白人普遍。

But African-Americans of normal weight appear to have higher rates of hypertension and diabetes than whites of normal weight. 'The question is, should [measures] for defining diabetes be different or the same for the [different] populations and are they associated with the same risk of cardiovascular disease?' said Dr. Correa. The collaboration, he said, may provide better comparisons.
然而体重正常的非洲裔美国人相比体重正常的白人似乎有更高的高血压及糖尿病患病率。“问题在于，定义糖尿病（的手段）对于（不同的）人群来说应该是相同的还是不同的？他们面临的心血管疾病危险是否是相同的？”科雷亚如是说。他说这个合作项目也许会提供更好的比较。

Researchers, who plan to use tools other than genetics, think more might be learned about blood pressure and heart and stroke risk by monitoring patients in real time using mobile devices rather than taking readings only in periodic office visits. For example, high blood pressure during sleep or spikes during exercise could indicate risks that don't show up in a routine measurement in the doctors' office.
研究人员还打算利用遗传学之外的其它工具。他们认为，通过利用移动设备对病人进行实时监测而不是只在病人定期到诊室就诊时才读取数据，人们可以对血压、心脏和中风了解得更多。比如，睡眠期间血压升高或者运动期间血压陡增可能预示着危险，这在医生诊室的常规测量中是不会出现的。

A big challenge is making sense of the huge amounts of data involved in sequencing DNA and linking it to medical records, diet and exercise habits and other variables that influence risk.
一个巨大的挑战是要弄清DNA测序中大量数据代表的意义并将它与病历、饮食和锻炼习惯以及影响到患病危险的其它变量关联起来。

'The analytical methods for sorting out these complex relationships are still in evolution,' said Dr. Loscalzo, of Brigham and Women's Hospital. 'The cost of sequencing is getting cheaper and cheaper. The hard part is analyzing the data.'
“整理这些复杂关系的分析方法尚在逐步完善之中，”布里格姆妇科医院的洛斯卡尔佐说，“DNA测序的成本越来越低了，难的部分是对数据进行分析。”