Lucchi Tiziano, Cesari Matteo, Vergani Carlo
Ambulatorio Malattie Metaboliche, UO Geriatria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano.
Ambulatorio Malattie Metaboliche, UO Geriatria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Università di Milano.
Recenti Prog Med. 2020 Jul-Aug;111(7):426-443. doi: 10.1701/3407.33925.
The atherosclerotic cardiovascular disease (ASCVD) represents the leading cause of death and disability not only in countries with a high degree of socio-economic development but also in low- middle-income countries. The study of atherosclerosis and the strategies to control ASCVD are evolving. All strategies emphasize the need to lower LDL cholesterol through an appropriate lifestyle and the use of lipid-lowering drugs. A therapy with statin with or without other lipid lowering drugs is recommended in secondary prevention. In primary prevention, the use of the lipid-lowering drug should instead take into account the cost-benefit ratio. Available evidence coming from clinical trials is useful to inform clinical choices but must be associated with a shared decision-making process between doctor and patient.
动脉粥样硬化性心血管疾病(ASCVD)不仅是社会经济高度发达国家,也是中低收入国家死亡和残疾的主要原因。动脉粥样硬化的研究以及控制ASCVD的策略正在不断发展。所有策略都强调需要通过适当的生活方式和使用降脂药物来降低低密度脂蛋白胆固醇。二级预防推荐使用他汀类药物治疗,可联合或不联合其他降脂药物。在一级预防中,降脂药物的使用应考虑成本效益比。来自临床试验的现有证据有助于指导临床选择,但必须与医生和患者之间的共同决策过程相结合。