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心血管疾病的一级预防:当代指南与文献综述

Primary prevention of cardiovascular disease: A review of contemporary guidance and literature.

作者信息

Stewart Jack, Manmathan Gavin, Wilkinson Peter

机构信息

Department of Cardiology, Ashford & St Peter's NHS Foundation Trust, London, UK; Institute of Cardiovascular Research, Biological Sciences, University of London, Surrey, UK.

Department of Cardiology, Ashford & St Peter's NHS Foundation Trust, London, UK.

出版信息

JRSM Cardiovasc Dis. 2017 Jan 1;6:2048004016687211. doi: 10.1177/2048004016687211. eCollection 2017 Jan-Dec.

Abstract

Cardiovascular disease is a significant and ever-growing problem in the United Kingdom, accounting for nearly one-third of all deaths and leading to significant morbidity. It is also of particular and pressing interest as developing countries experience a change in lifestyle which introduces novel risk factors for cardiovascular disease, leading to a boom in cardiovascular disease risk throughout the developing world. The burden of cardiovascular disease can be ameliorated by careful risk reduction and, as such, primary prevention is an important priority for all developers of health policy. Strong consensus exists between international guidelines regarding the necessity of smoking cessation, weight optimisation and the importance of exercise, whilst guidelines vary slightly in their approach to hypertension and considerably regarding their approach to optimal lipid profile which remains a contentious issue. Previously fashionable ideas such as the polypill appear devoid of in-vivo efficacy, but there remain areas of future interest such as the benefit of serum urate reduction and utility of reduction of homocysteine levels.

摘要

心血管疾病在英国是一个重大且日益严重的问题,占所有死亡人数的近三分之一,并导致严重的发病率。随着发展中国家生活方式发生变化,引入了心血管疾病的新风险因素,导致整个发展中世界心血管疾病风险激增,这一问题也尤为紧迫且备受关注。通过谨慎降低风险可减轻心血管疾病负担,因此,一级预防是所有卫生政策制定者的重要优先事项。国际指南对于戒烟、体重优化的必要性以及运动的重要性存在强烈共识,而在高血压治疗方法上指南略有不同,在最佳血脂水平治疗方法上差异很大,这仍是一个有争议的问题。以前流行的如复方药丸等观点似乎缺乏体内疗效,但仍有一些未来值得关注的领域,如降低血清尿酸的益处和降低同型半胱氨酸水平的效用。

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