Hermans M P, De Bacquer D, De Block C, Truyers C, Vankeirsbilck A, De Backer G
Rev Med Liege. 2014 Apr;69(4):200-9.
Cardiovascular disease (CVD) is the main cause of premature mortality in Europe. The burden of CVD could be reduced by controlling the major modifiable CVD risk factors (dyslipidaemia, arterial hypertension, hyperglycaemia, smoking, and physical inactivity) through lifestyle and dietary changes and appropriate drug therapies. The objective of this article is to assess the level of target achievement for key modifiable CVD risk factors in Belgium by referring to the data from four recent studies. The overall results show that the main CVD risk factors are poorly controlled in patients with established CVD and in patients at high CVD risk. Therapeutic targets may be incompletely reached because of the suboptimal implementation of European guidelines for CVD prevention in routine clinical practice (insufficient lifestyle and dietary adaptations; poor applications of drug therapy to control blood pressure, dyslipidaemia and hyperglycaemia) or because of the insufficient efficacy of currently available treatment options in some patients. This review provides clear and updated evidence for non-target achievement for all major risk factors, with four different study designs and inclusion criteria; it highlights the need for a more comprehensive and intensive application of recommendations of the European guidelines for CVD prevention in Belgium.
心血管疾病(CVD)是欧洲过早死亡的主要原因。通过生活方式和饮食改变以及适当的药物治疗来控制主要的可改变的心血管疾病风险因素(血脂异常、动脉高血压、高血糖、吸烟和身体活动不足),可以减轻心血管疾病的负担。本文的目的是参考最近四项研究的数据,评估比利时主要可改变的心血管疾病风险因素的目标达成水平。总体结果表明,在已确诊心血管疾病的患者和心血管疾病高风险患者中,主要的心血管疾病风险因素控制不佳。由于欧洲心血管疾病预防指南在常规临床实践中实施不理想(生活方式和饮食调整不足;药物治疗在控制血压、血脂异常和高血糖方面应用不佳),或者由于目前可用的治疗方案在某些患者中疗效不足,治疗目标可能无法完全实现。本综述通过四种不同的研究设计和纳入标准,为所有主要风险因素未达成目标提供了清晰且最新的证据;它强调了在比利时更全面、深入地应用欧洲心血管疾病预防指南建议的必要性。