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西班牙跨学科血管预防委员会关于更新的欧洲心血管预防指南的声明。

Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines.

机构信息

Sociedad Española-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, España.

Sociedad Española de Medicina de Familia y Comunitaria, Barcelona, España.

出版信息

Clin Investig Arterioscler. 2021 Mar-Apr;33(2):85-107. doi: 10.1016/j.arteri.2020.11.004. Epub 2021 Jan 22.

Abstract

We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.

摘要

我们呈现了更新的欧洲心血管预防指南的西班牙适应版本。在本次更新中,更加注重人群方法,特别是通过西班牙的饮食、休闲和主动交通政策促进身体活动和健康饮食。为了评估血管风险,应注意重新校准所使用的表格的重要性,通过将其适应当前风险因素流行率和血管疾病发病率的人群变化,特别关注慢性肾脏病的作用。在个体层面,关键要素是为行为改变提供个性化支持,坚持对高危人群和有血管疾病患者的药物治疗,促进身体活动,并戒除吸烟习惯。此外,还审查了最近的 PCSK9 抑制剂临床试验,以及简化降压药物治疗以改善控制和治疗依从性的必要性。对于有血管疾病或高血管疾病风险的 2 型糖尿病患者,当生活方式改变和二甲双胍不充分时,应优先考虑使用具有明确血管获益的药物。最后,还包括了外周动脉疾病和其他特定疾病的指南,以及反对在一级预防中开具抗血小板药物的建议。

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