Beaglehole R, Jackson R, Stewart A
Department of Community Health, University of Auckland School of Medicine.
N Z Med J. 1988 Jun 22;101(848):415-8.
A combination of the population strategy and the high risk strategy has been recommended for the prevention and control of coronary heart disease in New Zealand. In this paper, using data from a variety of sources, we estimate the potential relative benefits of these two strategies to reduce the contribution of diet and high blood cholesterol to coronary heart disease mortality in New Zealand. It is estimated that diet is responsible, at a minimum for between 22% (1600 deaths) and 39% (2800 deaths) of the coronary heart disease mortality in New Zealand each year. Achievement of the suggested short term dietary goals for the New Zealand population would have at least the same benefit as the identification and successful treatment of all people in the top 10% of the serum cholesterol distribution. This indicates that the population strategy should have higher priority in efforts to prevent and control coronary heart disease. Decisions concerning the level at which elevated blood cholesterol levels are treated pharmacologically will have important logistic and cost implications; national guidelines are required for the management of people with high blood cholesterol levels.
新西兰已建议将人群策略和高危策略相结合用于冠心病的防控。在本文中，我们利用来自各种来源的数据，估算这两种策略在降低饮食和高血胆固醇对新西兰冠心病死亡率的影响方面的潜在相对益处。据估计，饮食每年至少导致新西兰22%（1600例死亡）至39%（2800例死亡）的冠心病死亡。实现新西兰人群建议的短期饮食目标所带来的益处，至少与识别并成功治疗血清胆固醇分布处于前10%的所有人群相同。这表明在冠心病防控工作中，人群策略应具有更高优先级。关于对血胆固醇水平升高进行药物治疗的阈值的决策，将产生重要的后勤和成本影响；需要制定全国性指南来管理高血胆固醇人群。
