Center for Health Decision Science, Harvard School of Public Health, Boston, MA.
Prog Cardiovasc Dis. 2013 Nov-Dec;56(3):336-43. doi: 10.1016/j.pcad.2013.09.014. Epub 2013 Sep 28.
Successful efforts to reduce cardiovascular disease in many countries have come as a result of both population based interventions and individually guided interventions. Guidelines serve two purposes directed at the promotion of the individually guided interventions. First, they serve as a method to summarize approved and successful life-style and medical interventions to reduce the burden of cardiovascular disease. Second, they guide health providers on how to identify those at high risk for cardiovascular disease and who might benefit from the available interventions. However, guidelines have been increasingly complex and at times contradictory from one body to another or they may not exist at all in certain countries. This paper will review the current status of guidelines for the region as well as for individual countries. Guidelines for the prevention of CVD as a whole will be evaluated as well as guidelines for individual risk factors such as hypertension, cholesterol, and diabetes. Finally, this paper will address the pitfalls of individual risk factor based guidelines as opposed to the absolute risk approach integrating multiple risk factors into one comprehensive set of guidelines.
成功降低许多国家心血管疾病的努力，既是基于人群的干预措施，也是个人指导干预措施的结果。指南有两个目的，一是促进个人指导干预措施，二是指导卫生保健提供者如何识别心血管疾病高危人群以及哪些人可能从现有干预措施中受益。然而，指南变得越来越复杂，有时彼此之间相互矛盾，或者在某些国家根本不存在。本文将回顾该地区以及个别国家的指南现状。将对 CVD 预防的总体指南以及高血压、胆固醇和糖尿病等个别危险因素的指南进行评估。最后，本文将讨论基于个体危险因素的指南的缺陷，以及将多个危险因素综合成一套全面的指南的绝对风险方法的优势。
