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降低心血管疾病风险的血脂异常管理:2020 年美国退伍军人事务部和美国国防部临床实践指南更新概要。

Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

机构信息

Uniformed Services University of the Health Sciences, Bethesda, Maryland (P.G.O., M.J.A., B.E.N.).

U.S. Department of Veterans Affairs Pharmacy Benefits Management Services, Scottsdale, Arizona (C.K.).

出版信息

Ann Intern Med. 2020 Nov 17;173(10):822-829. doi: 10.7326/M20-4648. Epub 2020 Sep 22.

Abstract

DESCRIPTION

In June 2020, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) released a joint update of their clinical practice guideline for managing dyslipidemia to reduce cardiovascular disease risk in adults. This synopsis describes the major recommendations.

METHODS

On 6 August to 9 August 2019, the VA/DoD Evidence-Based Practice Work Group (EBPWG) convened a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions, systematically searched and evaluated the literature (English-language publications from 1 December 2013 to 16 May 2019), and developed 27 recommendations and a simple 1-page algorithm. The recommendations were graded by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

RECOMMENDATIONS

This synopsis summarizes key features of the guideline in 7 crucial areas: targeting of statin dose (not low-density lipoprotein cholesterol goals), additional tests for risk prediction, primary and secondary prevention, laboratory testing, physical activity, and nutrition.

摘要

描述

2020 年 6 月,美国退伍军人事务部(VA)和美国国防部(DoD)发布了联合更新的血脂异常管理临床实践指南,以降低成年人的心血管疾病风险。本概要描述了主要建议。

方法

2019 年 8 月 6 日至 8 月 9 日,VA/DoD 循证实践工作组(EBPWG)召集了一次联合 VA/DoD 指南制定工作会议,包括临床利益相关者,并符合医学研究所值得信赖的临床实践指南的原则。指南小组提出了关键问题,系统地搜索和评估了文献(2013 年 12 月 1 日至 2019 年 5 月 16 日的英文出版物),并制定了 27 项建议和一个简单的 1 页算法。建议使用 GRADE(推荐评估、制定和评估分级)系统进行分级。

建议

本概要总结了指南在 7 个关键领域的关键特征:他汀类药物剂量(而不是低密度脂蛋白胆固醇目标)的靶向、风险预测的附加测试、一级和二级预防、实验室检测、身体活动和营养。

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