Castelli W P
National Heart, Lung and Blood Institute, Framingham, Massachusetts 01701.
Can J Cardiol. 1988 Jul;4 Suppl A:5A-10A.
The USA is about to launch a massive campaign to identify those members of the population at risk for coronary artery disease (CAD). A screening process based on the high blood pressure campaign started in the 1970s aims at identifying those people with elevated cholesterol so measures can be taken to prevent fatal or nonfatal heart attacks. Data from 35 years of the Framingham Heart Study have shown that factors other than total or low density lipoprotein (LDL) cholesterol must be considered when evaluating CAD risk. In fact low levels of high density lipoprotein (HDL) cholesterol are as much a risk factor for CAD as high LDL cholesterol. The best simple test for predicting CAD is the ratio of total:HDL cholesterol and using this criterion, approximately half the population of North America is at risk for heart attack. This highlights the necessity for a screening program of cholesterol levels, and as there are tests available which can measure cholesterol in under 10 mins, the time should soon be here that everyone knows their CAD risk.
美国即将发起一场大规模运动，以识别那些有患冠状动脉疾病（CAD）风险的人群。基于20世纪70年代开展的高血压防治运动的筛查程序，旨在识别那些胆固醇水平升高的人，以便采取措施预防致命或非致命性心脏病发作。弗雷明汉心脏研究35年的数据表明，在评估CAD风险时，除了总胆固醇或低密度脂蛋白（LDL）胆固醇外，还必须考虑其他因素。事实上，高密度脂蛋白（HDL）胆固醇水平低与LDL胆固醇水平高一样，都是CAD的危险因素。预测CAD的最佳简易检测方法是总胆固醇与HDL胆固醇的比值，根据这一标准，北美约一半人口有心脏病发作风险。这凸显了开展胆固醇水平筛查项目的必要性，而且由于现有检测方法可在10分钟内测量胆固醇，很快每个人都将知晓自己患CAD的风险。
