Li Jian-Jun, Zhao Shui-Ping, Zhao Dong, Lu Guo-Ping, Peng Dao-Quan, Liu Jing, Chen Zhen-Yue, Guo Yuan-Lin, Wu Na-Qiong, Yan Sheng-Kai, Wang Zeng-Wu, Gao Run-Lin
National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
J Geriatr Cardiol. 2023 Sep 28;20(9):621-663. doi: 10.26599/1671-5411.2023.09.008.
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death among urban and rural residents in China, and elevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for ASCVD. Considering the increasing burden of ASCVD, lipid management is of the utmost importance. In recent years, research on blood lipids has made breakthroughs around the world, hence a revision of China guidelines for lipid management is imperative, especially since the target lipid levels in the general population vary in respect to the risk of ASCVD. The level of LDL-C, which can be regarded as appropriate in a population without frisk factors, can be considered abnormal in people at high risk of developing ASCVD. As a result, the "Guidelines for the prevention and treatment of dyslipidemia" were adapted into the "China Guidelines for Lipid Management" (henceforth referred to as the new guidelines) by an Experts' committee after careful deliberation. The new guidelines still recommend LDL-C as the primary target for lipid control, with CVD risk stratification to determine its target value. These guidelines recommend that moderate intensity statin therapy in adjunct with a heart-healthy lifestyle, be used as an initial line of treatment, followed by cholesterol absorption inhibitors or/and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, as necessary. The new guidelines provide guidance for lipid management across various age groups, from children to the elderly. The aim of these guidelines is to comprehensively improve the management of lipids and promote the prevention and treatment of ASCVD by guiding clinical practice.
动脉粥样硬化性心血管疾病（ASCVD）是中国城乡居民死亡的主要原因，而低密度脂蛋白胆固醇（LDL-C）升高是ASCVD的一个危险因素。鉴于ASCVD负担日益加重，血脂管理至关重要。近年来，全球血脂研究取得了突破，因此修订中国血脂管理指南势在必行，尤其是考虑到一般人群的血脂目标水平因ASCVD风险而异。在无危险因素人群中可视为正常的LDL-C水平，在发生ASCVD高风险人群中则可能被视为异常。因此，专家委员会经过仔细审议，将《血脂异常防治指南》改编为《中国血脂管理指南》（以下简称新指南）。新指南仍推荐将LDL-C作为血脂控制的主要目标，并通过心血管疾病（CVD）风险分层来确定其目标值。这些指南建议，以中等强度他汀类药物治疗联合健康的心脏生活方式作为初始治疗方案，必要时可加用胆固醇吸收抑制剂或/和前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂。新指南为从儿童到老年人的各年龄组血脂管理提供了指导。这些指南的目的是通过指导临床实践全面改善血脂管理，促进ASCVD的防治。
