Erhardt Leif, Moller Robert, Puig Juan García
Department of Cardiology, University of Lund, Malmö University Hospital, Sweden.
Vasc Health Risk Manag. 2007;3(5):587-603.
The continued movement away from the treatment of individual cardiovascular (CV) risk factors to managing overall and lifetime CV risk is likely to have a significant impact on slowing the rate of increase in cardiovascular disease (CVD). However, the management of CVD is currently far from optimal even in parts of the world with well-developed and well-funded healthcare systems. Effective implementation of the knowledge, treatment guidelines, diagnostic tools, therapeutic interventions, and management programs that exist for CVD continues to evade us. A thorough understanding of the multifactorial nature of CVD is essential to its effective management. Improvements continue to be made to management guidelines, risk assessment tools, treatments, and care programs pertaining to CVD. Ultimately, however, preventing the epidemic of CVD will require a combination of both medical and public health approaches. In addition to improvements in the "high-risk" strategy, which forms the basis of current CVD management, an increase in the utilization of population-based management strategies needs to be made to attempt to reduce the number of patients falling within the "at-risk" stratum for CVD. This review outlines how a comprehensive approach to CVD management might be achieved.
从治疗个体心血管（CV）危险因素转向管理整体和终生CV风险的持续转变，可能会对减缓心血管疾病（CVD）的增长率产生重大影响。然而，即使在医疗保健系统发达且资金充足的世界部分地区，CVD的管理目前也远未达到最佳状态。有效实施现有的关于CVD的知识、治疗指南、诊断工具、治疗干预措施和管理计划仍然难以实现。对CVD多因素性质的透彻理解对其有效管理至关重要。针对CVD的管理指南、风险评估工具、治疗方法和护理计划仍在不断改进。然而，最终预防CVD的流行将需要医学和公共卫生方法的结合。除了改进构成当前CVD管理基础的“高风险”策略外，还需要增加基于人群的管理策略的应用，以试图减少处于CVD“风险”阶层的患者数量。本综述概述了如何实现CVD管理的综合方法。
