Mendis Shanthi, Lindholm Lars H, Mancia Giuseppe, Whitworth Judith, Alderman Michael, Lim Stephen, Heagerty Tony
Cardiovascular Diseases, World Health Organization, Geneva, Switzerland.
J Hypertens. 2007 Aug;25(8):1578-82. doi: 10.1097/HJH.0b013e3282861fd3.
Cardiovascular disease (CVD) is the leading cause of the growing global disease burden due to non-communicable diseases. For successful prevention and control of CVD, strategies that focus on individuals need to complement population-wide strategies. Strategies that focus on individuals are cost effective only when targeted at high-risk groups. Risk prediction tools that easily and accurately predict an individual's absolute risk of CVD are key to targeting limited resources at high-risk individuals who are likely to benefit the most. Health systems in low-income countries do not have the basic infrastructure facilities to support resource-intensive risk prediction tools, particularly in primary healthcare. The WHO/ISH charts presented here, enable the prediction of future risk of heart attacks and strokes in people living in low and middle income countries, for the first time. Furthermore, since the charts use simple variables they can be applied even in low resource settings. Thus the WHO/ISH risk predication charts and the accompanying guideline will improve the effectiveness of cardiovascular risk management even in settings which do not have sophisticated technology.
心血管疾病(CVD)是全球非传染性疾病导致的疾病负担不断增加的主要原因。为了成功预防和控制心血管疾病,关注个体的策略需要与针对全体人群的策略相辅相成。只有针对高危人群,关注个体的策略才具有成本效益。能够轻松、准确地预测个体患心血管疾病绝对风险的风险预测工具,是将有限资源用于可能受益最大的高危个体的关键。低收入国家的卫生系统没有基本的基础设施来支持资源密集型的风险预测工具,尤其是在初级卫生保健领域。本文介绍的世界卫生组织/国际高血压学会(WHO/ISH)图表首次能够预测低收入和中等收入国家人群未来心脏病发作和中风的风险。此外,由于这些图表使用的变量简单,即使在资源匮乏的环境中也可以应用。因此,即使在没有先进技术的环境中,WHO/ISH风险预测图表及相关指南也将提高心血管疾病风险管理的有效性。