Graham Ian M
Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin.
Curr Opin Cardiol. 2005 Sep;20(5):430-9. doi: 10.1097/01.hco.0000176405.56119.54.
To summarize the recommendations of the Third Joint European Society's Task Force on Cardiovascular Disease Prevention in Clinical Practice so that these may be made accessible to a wider audience.
The relative importance of population and high-risk strategies for cardiovascular disease prevention is summarized. The guidelines stress the primacy of total risk assessment to guide management decisions. The hazards of decisions based on assessment of single risk factors is illustrated. Compared with earlier guidelines, the focus has changed from coronary heart disease to total cardiovascular disease prevention. A new system for predicting total cardiovascular disease mortality risk (Systematic Coronary Risk Evaluation) is presented. Explicit clinical priorities are defined.
Total cardiovascular risk should be assessed before making management decisions. Individuals with established cardiovascular disease and those with high total cardiovascular risk gain most from preventive advice. This high-risk approach should be complemented by a population-based preventive strategy.
总结第三届欧洲临床实践心血管疾病预防联合工作组的建议,以便更广泛的受众能够了解这些建议。
总结了心血管疾病预防中人群策略和高危策略的相对重要性。指南强调全面风险评估对于指导管理决策的首要地位。阐述了基于单一风险因素评估进行决策的危害。与早期指南相比,重点已从冠心病预防转向全面心血管疾病预防。提出了一种预测心血管疾病总死亡风险的新系统(系统性冠心病风险评估)。明确了临床优先事项。
在做出管理决策之前,应评估心血管疾病总风险。已确诊心血管疾病的个体以及心血管疾病总风险高的个体从预防性建议中获益最大。这种高危策略应辅以基于人群的预防策略。