Pearson Thomas A
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, New York, USA.
Health Aff (Millwood). 2007 Jan-Feb;26(1):49-60. doi: 10.1377/hlthaff.26.1.49.
Despite reductions in cardiovascular disease (CVD) mortality, current evidence suggests that CVD is not being prevented but, rather, is being made less lethal. Evidence-based guidelines have been developed for secondary, primary, and community-based prevention. To improve compliance with secondary prevention guidelines, programs must better organize and monitor care. Primary prevention requires assessment of risk in asymptomatic people, to yield cost-effective benefits. CVD prevention at the societal level should target deleterious behavior in community settings, using effective public health interventions. Policy options that involve multiple preventive approaches offer the best opportunity to minimize the economic and social burdens of CVD.
尽管心血管疾病（CVD）死亡率有所下降，但目前的证据表明，心血管疾病并未得到预防，而是致死率降低了。针对二级预防、一级预防和社区预防制定了循证指南。为提高对二级预防指南的依从性，各项目必须更好地组织和监测护理工作。一级预防需要对无症状人群进行风险评估，以产生具有成本效益的效益。社会层面的心血管疾病预防应以社区环境中的有害行为为目标，采用有效的公共卫生干预措施。涉及多种预防方法的政策选择为最大限度地减轻心血管疾病的经济和社会负担提供了最佳机会。
