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考虑因素和指导意见:关于构建、组织和运行心脏代谢预防单位:美洲心脏病学会的共识声明。

Considerations and Guidance for the Structure, Organisation, and Operation of Cardiometabolic Prevention Units: A Consensus Statement of the Inter-American Society of Cardiology.

机构信息

Unidad Cardiológica del Caribe, Macuto, VE.

Unidad de Medicina Cardiometabólica La Floresta, Caracas, VE.

出版信息

Glob Heart. 2021 Apr 27;16(1):27. doi: 10.5334/gh.960.

Abstract

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, particularly in low- and middle-income regions such as Latin America. This is because of the combination and interaction in different proportions of a high prevalence of cardiometabolic risk factors and socio-economic and cultural characteristics. This reality brings about the need to change paradigms to consistently and systematically boost cardiovascular prevention as the most cost-effective medium- to long-term strategy to reduce their prevalence in medium- and low-resource countries, not only in Latin America but also in other global regions. To achieve the therapeutic goals in various diseases, including CVD, the current literature demonstrates that the most effective way is to carry out the patient's diagnosis and treatment in multidisciplinary units. For this reason, the Inter American Society of Cardiology (IASC) proposes the creation of cardiometabolic prevention units (CMPUs) as a regional initiative exportable throughout the world to standardise cardiovascular prevention based on the best available evidence. This ensures homogeneity in the global management of cardiometabolic risk factors and access to quality medicine independently of the population's social situation. These guidelines, written by a panel of experts in cardiovascular prevention, defines what a CMPU is, its objectives and the minimum requirements for it, as well as proposing three categories and suggesting an operational scheme. It must be used as a guide for all individuals or centres that, aware of the need for multidisciplinary and standardised work, want to create a unit for the comprehensive management of cardiometabolic risk established as an international research network. Lastly, the document makes meaningful points on the determination of cardiovascular risk and its importance. These guidelines do not cover specific targets and therapeutic schemes, as these topics will be extensively discussed in another SIAC publication, namely a statement on residual cardiometabolic risk.

摘要

心血管疾病(CVDs)仍然是全球范围内的主要死因,尤其是在拉丁美洲等中低收入地区。这是因为心血管代谢危险因素的高发以及社会经济和文化特征以不同的比例组合和相互作用。这种现实需要改变范式,以持续和系统地加强心血管预防,作为降低中低收入国家 CVD 患病率的最具成本效益的中短期策略,不仅在拉丁美洲,而且在其他全球地区也是如此。为了实现包括 CVD 在内的各种疾病的治疗目标,当前文献表明,最有效的方法是在多学科单位对患者进行诊断和治疗。出于这个原因,泛美心脏病学会(IASC)提出创建心脏代谢预防单位(CMPU),作为一项可在全球范围内推广的区域倡议,以根据最佳现有证据标准化心血管预防。这确保了全球范围内心血管代谢危险因素管理的同质化,以及独立于人群社会状况获得优质医疗的机会。这些由心血管预防专家小组撰写的指南定义了 CMPU 是什么、它的目标和最低要求,并提出了三个类别并提出了一个操作方案。它必须作为所有个人或中心的指南使用,这些个人或中心意识到需要多学科和标准化的工作,希望创建一个全面管理心血管代谢风险的单位,该单位将作为一个国际研究网络建立。最后,该文件对心血管风险的确定及其重要性提出了有意义的观点。这些指南不涵盖特定目标和治疗方案,因为这些主题将在另一份 IASC 出版物中进行广泛讨论,即关于残余心血管代谢风险的声明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/8086731/eb3b6ad4da3f/gh-16-1-960-g1.jpg

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