McNeal Catherine J, Toth Peter P, Wilson Don P
Associate Professor of Internal Medicine, Division of Cardiology, Associate Professor of Pediatrics, Baylor Scott & White Health, Texas A&M Health Science Center, Temple, TX, USA.
Director of Preventive Cardiology, CGH Medical Center, Professor of Clinical Family and Community Medicine, University of Illinois School of Medicine, Peoria, IL; Adjunct Associate Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Fam Pract. 2015 Dec;64(12 Suppl):S22-30.
Worldwide, guidelines support early identification, aggressive lifestyle management, and pharmacologic lipid lowering therapies when appropriate in youth with FH. These guidelines are aimed at improving the unending cycle of premature CHD in families despite the vast body of knowledge regarding the natural history of undiagnosed and untreated FH. Although valid concerns have been raised about treating youth other than those with FH with lipid-lowering pharmaceuticals, we believe the preponderance of the evidence laid forth by multiple professional societies from the United States and abroad is clearly weighted in favor of early diagnosis and treatment with lifestyle modification, to prevent the acquisition of other risk factors, and habituation to lifelong low-fat diet and adequate physical activity. We can think of no other instance where providers in the field of family medicine could have such a profound impact on the current and future health of child and parent and even future generations.
在全球范围内,指南支持对患有家族性高胆固醇血症(FH)的青少年进行早期识别、积极的生活方式管理以及在适当的时候进行药物降脂治疗。尽管有大量关于未诊断和未治疗的FH自然史的知识,但这些指南旨在改善家庭中过早发生冠心病的无休止循环。虽然有人对用降脂药物治疗非FH的青少年提出了合理的担忧,但我们认为,美国和国外多个专业协会提出的证据明显倾向于早期诊断,并通过生活方式改变进行治疗,以预防其他危险因素的形成,并养成终身低脂饮食和适当体育活动的习惯。我们想不出家庭医学领域的医疗服务提供者在其他任何情况下能对儿童、父母乃至子孙后代的当前和未来健康产生如此深远的影响。