OLIVER M F
Bull World Health Organ. 1962;27(3):409-19.
In this report an attempt is made to assess the value of reducing elevated plasma lipids in the treatment and prevention of ischaemic heart disease. The main relationships between lipids and atheroma formation and between lipids and intravascular thrombosis are outlined, although no general review is undertaken. While there is probably a causal relationship between hypercholesterolaemia and the early development of atheroma, the nature of the association between elevated plasma lipids and ischaemic heart disease is uncertain. Epidemiological studies have indicated that certain environmental factors can be positively correlated with ischaemic heart disease and one of these is the intake of saturated fat. Although there is no entirely satisfactory method for reducing elevated plasma lipids over an indefinite period, a strict diet substituting unsaturated for saturated fats is the best at present available.Certain long-term dietary and hormonal studies of the benefit of reducing elevated plasma lipids in patients with ischaemic heart disease are reviewed. Provisionally, it is concluded that continued reduction of plasma lipids does not improve prognosis once myocardial infarction has occurred. Thus, the next step is a study of the value of reducing elevated plasma lipids in otherwise apparently healthy men. Some of the problems involved in the establishment of such a study are discussed.
在本报告中，我们尝试评估降低升高的血脂水平在治疗和预防缺血性心脏病方面的价值。尽管未进行全面综述，但概述了血脂与动脉粥样硬化形成以及血脂与血管内血栓形成之间的主要关系。虽然高胆固醇血症与动脉粥样硬化的早期发展之间可能存在因果关系，但血浆脂质升高与缺血性心脏病之间关联的性质尚不确定。流行病学研究表明，某些环境因素与缺血性心脏病呈正相关，其中之一是饱和脂肪的摄入量。尽管目前尚无一种能在无限期内有效降低升高的血脂水平的完全令人满意的方法，但用不饱和脂肪替代饱和脂肪的严格饮食是目前可用的最佳方法。本文回顾了一些关于降低缺血性心脏病患者升高的血脂水平的长期饮食和激素研究。初步得出结论，一旦发生心肌梗死，持续降低血脂并不能改善预后。因此，下一步是研究在其他方面看似健康的男性中降低升高的血脂水平的价值。讨论了开展此类研究所涉及的一些问题。
