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成人动脉粥样硬化性心血管疾病风险降低的血胆固醇治疗:2013 年美国心脏病学会/美国心脏协会胆固醇指南概要。

Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline.

出版信息

Ann Intern Med. 2014 Mar 4;160(5):339-43. doi: 10.7326/M14-0126.

Abstract

DESCRIPTION

In November 2013, the American College of Cardiology and American Heart Association (ACC/AHA) released a clinical practice guideline on the treatment of blood cholesterol to reduce cardiovascular risk in adults. This synopsis summarizes the major recommendations.

METHODS

In 2008, the National Heart, Lung, and Blood Institute convened the Adult Treatment Panel (ATP) IV to update the 2001 ATP-III cholesterol guidelines using a rigorous process to systematically review randomized, controlled trials (RCTs) and meta-analyses of RCTs that examined cardiovascular outcomes. The panel commissioned independent systematic evidence reviews on low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol goals in secondary and primary prevention and the effect of lipid drugs on atherosclerotic cardiovascular disease events and adverse effects. In September 2013, the panel's draft recommendations were transitioned to the ACC/AHA.

RECOMMENDATIONS

This synopsis summarizes key features of the guidelines in 8 areas: lifestyle, groups shown to benefit from statins, statin safety, decision making, estimation of cardiovascular disease risk, intensity of statin therapy, treatment targets, and monitoring of statin therapy.

摘要

描述

2013 年 11 月,美国心脏病学会和美国心脏协会(ACC/AHA)发布了一项关于治疗血液胆固醇以降低成年人心血管风险的临床实践指南。本概要总结了主要建议。

方法

2008 年,美国国立心肺血液研究所召集成人治疗专家组(ATP)IV 用严格的程序更新 2001 年 ATP-III 胆固醇指南,系统审查了随机对照试验(RCT)和 RCT 的荟萃分析,以检查心血管结局。专家组委托对二级和一级预防中的低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇目标以及降脂药物对动脉粥样硬化性心血管疾病事件和不良反应的影响进行独立的系统证据审查。2013 年 9 月,专家组的建议草案过渡到 ACC/AHA。

建议

本概要总结了指南在 8 个领域的关键特征:生活方式、从他汀类药物中获益的人群、他汀类药物安全性、决策制定、心血管疾病风险估计、他汀类药物治疗强度、治疗目标和他汀类药物治疗监测。

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