Clearfield Michael
University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA.
Curr Atheroscler Rep. 2006 Sep;8(5):390-6. doi: 10.1007/s11883-006-0036-6.
Cardiovascular disease remains the leading cause of death in both men and women in the United States. Treating elevated low-density lipoprotein (LDL) cholesterol has been shown to be very effective in reducing the rate of coronary heart disease (CHD) in primary prevention trials; however, the data are not as robust for treating individuals categorized at either lower risk for CHD or with below-average LDL cholesterol levels. The next frontier for investigation will include strategies to determine who in these lower risk categories should be treated with statins. The growing epidemics of obesity, diabetes, and metabolic syndrome also loom as major problems that need to be incorporated into any strategy that focuses on the prevention of cardiovascular disease. In individuals with multiple cardiovascular risk factors, combination therapies tailored to address each individual's risk profile need to be considered to best decrease the likelihood of their first coronary event.
在美国，心血管疾病仍然是男性和女性的首要死因。在一级预防试验中，治疗升高的低密度脂蛋白（LDL）胆固醇已被证明在降低冠心病（CHD）发病率方面非常有效；然而，对于治疗冠心病风险较低或LDL胆固醇水平低于平均水平的个体，数据并不那么确凿。下一个研究前沿将包括确定这些低风险类别中的哪些人应该接受他汀类药物治疗的策略。肥胖、糖尿病和代谢综合征的流行趋势日益严重，这也是需要纳入任何以预防心血管疾病为重点的策略中的主要问题。对于有多种心血管危险因素的个体，需要考虑根据每个人的风险状况量身定制联合治疗方案，以最大程度降低首次发生冠心病事件的可能性。
