J Atheroscler Thromb. 2009;16(6):799-806. doi: 10.5551/jat.2352. Epub 2009 Dec 22.
In Japan, it is believed that guidelines for lifestyle-related disease are used in routine clinical practice, however, there are few reports on the actual rate of healthcare conducted in accordance with these guidelines by general practitioners and on their usefulness in preventing cardiovascular events. Therefore, the Heart Care Network (HCN) groups were organized mainly by general practitioners treating lifestyle diseases in 62 areas of Japan.
The HCN has collected data on lifestyle diseases in high-risk patients in routine practices and investigated management conditions, guideline target achievement rates and medication. Additionally, the incidence of cardiovascular events was assessed.
We analyzed 14,064 cases. The lipid profile, blood pressure, glycemic control were significantly improved over the 3 years. The incidence of cardiovascular events were significantly reduced by the achievement of target LDL cholesterol, systolic blood pressure and hemoglobin A1c and even after adjustment for age, gender, history of myocardial infarction, the reduction of these lifestyle-related parameters remains significant.
These results revealed the current trends in the healthcare activities of general practitioners, the management conditions for lifestyle diseases in CHD high-risk patients and their effects on reducing cardiovascular events.
在日本，人们普遍认为与生活方式相关疾病的指南被用于常规临床实践中，但关于全科医生实际遵循这些指南的医疗保健的比率以及它们在预防心血管事件中的有效性的报告较少。因此，主要由治疗生活方式疾病的全科医生在日本的 62 个地区组织了心脏保健网络 (HCN) 小组。
HCN 收集了常规实践中高危患者的生活方式疾病数据，并调查了管理条件、指南目标达标率和药物治疗情况。此外，还评估了心血管事件的发生率。
我们分析了 14064 例病例。血脂谱、血压、血糖控制在 3 年内得到显著改善。通过实现目标 LDL 胆固醇、收缩压和糖化血红蛋白达标，心血管事件的发生率显著降低，即使在调整年龄、性别、心肌梗死史后，这些与生活方式相关的参数的降低仍然具有显著意义。
这些结果揭示了全科医生医疗保健活动的现状、冠心病高危患者生活方式疾病的管理情况及其在降低心血管事件中的作用。
