Wiersma Tjerk, Smulders Yvo M, Stehouwer Coen D A, Konings Karin T S, Lanphen Joke
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(36):A5104.
The decision whether to treat individuals not previously known to have cardiovascular disease is based on a new risk table in which Dutch research data on morbidity have been incorporated. An explanation of the roles of additional risk factors ignored in the cardiovascular risk function, such as a sedentary lifestyle and a high BMI, is provided. A method for estimating the cardiovascular risk in patients with diabetes mellitus and rheumatoid arthritis has been developed. New recommendations concerning the measurement of blood pressure at home and in the ambulatory setting have been formulated. The recommendations for the choice of antihypertensive drugs have been revised. The recommendations on handling therapy-resistant hypertension are provided. Recommendations for choosing statins based on a current cost-effectiveness analysis are provided.
对于此前未知患有心血管疾病的个体是否进行治疗的决策,是基于一个纳入了荷兰发病率研究数据的新风险表做出的。文中对心血管风险函数中被忽略的其他风险因素(如久坐的生活方式和高体重指数)的作用进行了解释。已开发出一种估算糖尿病和类风湿关节炎患者心血管风险的方法。已制定了关于在家中和动态环境下测量血压的新建议。关于抗高血压药物选择的建议已修订。提供了处理难治性高血压的建议。基于当前成本效益分析提供了选择他汀类药物的建议。