Borhani N O
Am J Cardiol. 1977 Aug;40(2):251-9. doi: 10.1016/0002-9149(77)90016-9.
The question is whether alteration of risk factors will aid primary and secondary prevention of coronary heart disease. Critical review of available evidence indicates that inferences have been made about the beneficial effects of risk factor modification without an adequate test of the hypothesis. Trial interventions to assess the efficacy of serum cholesterol-lowering measures have had negative or equivocal results. It remains to be seen whether the findings of clinical trials on hypertension can be applied toward primary prevention of coronary heart disease in the community. The cigarette smoking habit seems to be unique among coronary heart disease risk factors. The evidence appears sufficient to justify serious consideration of a strategy of preventing the smoking habit now, persuading patients to stop and encouraging teenagers not to start.
问题在于改变风险因素是否有助于冠心病的一级和二级预防。对现有证据的批判性审视表明，在未对该假设进行充分检验的情况下，就对风险因素改变的有益效果进行了推断。评估降低血清胆固醇措施疗效的试验性干预取得了负面或不明确的结果。关于高血压的临床试验结果能否应用于社区冠心病的一级预防还有待观察。吸烟习惯在冠心病风险因素中似乎是独特的。现有证据似乎足以支持认真考虑现在就采取一项预防吸烟习惯的策略，说服患者戒烟并鼓励青少年不要开始吸烟。
