Cardiology Section, Temple University Medical Center, Philadelphia, PA 19140, USA.
J Nucl Cardiol. 2011 Dec;18(6):1021-5. doi: 10.1007/s12350-011-9415-7. Epub 2011 Aug 2.
Clinical measures of cardiovascular disease risk (CVD) are important tools for establishing therapy to lower CVD risk. Risk assessment has come under criticism because clinical measures can underestimate or overestimate CVD risk. We assessed CVD risk in 252 subjects without evidence of CVD to establish therapy of one or more risk factors from clinical indications. The subjects all had intermediate CVD risk using the Framingham score.
Average age was 59.1 years. 23.8% were smokers, 59.1% were hypertensive, 65.1% had hyperlipidemia. BMI was greater than 30 kg/M(2) in 56% and diabetes was present in 43.7%. In this cohort, 86.9% required therapy for hypertension or hyperlipidemia, and this proportion increased to 95.6% when subjects with diabetes were included. Of the remaining 4.4% (11 subjects), 7 reached intermediate risk based on cigarette smoking and 4 based on age >65 years old. Among diabetics, 94/110 had another risk factor and would require statin and ACE or ARB therapy.
Of subjects at intermediate risk for CVD, 98.4% would not require further testing to decide on therapy to lower CVD risk. Although 16 diabetic subjects had no other risk factors, current guidelines suggest that these subjects should be treated to reduce CVD risk.
心血管疾病风险的临床评估（CVD）是确定降低 CVD 风险治疗方法的重要工具。由于临床评估可能低估或高估 CVD 风险，因此风险评估受到了批评。我们评估了 252 名无 CVD 证据的受试者的 CVD 风险，以根据临床指征对一个或多个危险因素进行治疗。这些受试者的Framingham 评分均显示为中度 CVD 风险。
平均年龄为 59.1 岁。23.8%为吸烟者，59.1%为高血压患者，65.1%为高脂血症患者。56%的 BMI 大于 30kg/m2，43.7%患有糖尿病。在该队列中，86.9%的患者需要治疗高血压或高脂血症，当包括糖尿病患者时，这一比例增加到 95.6%。其余 4.4%（11 名受试者）中，有 7 名因吸烟而处于中等风险，4 名因年龄>65 岁而处于中等风险。在糖尿病患者中，110 名中有 94 名有其他危险因素，需要他汀类药物和 ACE 或 ARB 治疗。
在 CVD 中度风险的受试者中，98.4%不需要进一步检测来决定降低 CVD 风险的治疗方法。尽管有 16 名糖尿病患者没有其他危险因素，但目前的指南建议对这些患者进行治疗以降低 CVD 风险。
