Klose G
Internistische Praxisgemeinschaft Dres. T. Beckenbauer, S. Maierhof, Hans-Thoma-Strasse 31, Bremen, Germany.
Internist (Berl). 2011 Mar;52(3):328-35. doi: 10.1007/s00108-010-2799-7.
Prevention is a major contributor to the decline in cardiovascular morbidity and mortality. Cardiovascular diseases still are the leading cause of death (42%) in Germany and indicate unmet preventive needs. Limitations of healthy lifestyle, the basis of many recommendations, include insufficient compliance and efficacy in individual cases. In their latest metaanalysis the Cholesterol Treatment Trialists' Collaborators showed updated estimates of treatment effects of statins including more or less intensive regimens.The average reduction in major vascular events was 21% per 1.0 mmol/l reduction in LDL cholesterol. Appropriateness of receiving lipid modulating treatment in the population will be discussed in the light of controversial recommendations in treatment strategies. Residual risk in statin treated patients may be ameliorated by options beyond LDL-lowering. Suggestions for clinical practice are provided on the background of clinical relevant characteristics of current lipid lowering drugs and future developments are outlined.
预防是心血管疾病发病率和死亡率下降的主要因素。心血管疾病仍是德国的主要死因（42%），表明存在未满足的预防需求。健康生活方式作为许多建议的基础，存在局限性，包括个体依从性不足和效果不佳。胆固醇治疗试验协作组在其最新的荟萃分析中展示了他汀类药物治疗效果的最新评估，包括不同强度的治疗方案。低密度脂蛋白胆固醇每降低1.0 mmol/L，主要血管事件的平均降幅为21%。鉴于治疗策略中存在争议的建议，将讨论人群中接受调脂治疗的适宜性。他汀类药物治疗患者的残余风险可能通过降低低密度脂蛋白以外的方法得到改善。基于当前降脂药物的临床相关特征，为临床实践提供了建议，并概述了未来的发展方向。
