Faculty of Health, Charles Darwin University, Casuarina, Australia.
Maroondah Hospital, Eastern Health, Melbourne, Australia.
J Transl Med. 2024 Feb 29;22(1):215. doi: 10.1186/s12967-024-04959-5.
Cardiovascular diseases (CVDs) are the leading cause of death around the world. Most CVDs-related death can be prevented by the optimal management of risk factors such as unhealthy diet and physical inactivity. Clinical practice guidelines (CPGs) for CVDs, provide some evidence-based recommendations which help healthcare professionals to achieve the best care for patients with CVDs. This systematic review aims to appraise the methodological quality of CPGs systematically and summarize the recommendations of self-managed non-pharmacological interventions for the prevention and management of CVDs provided by the selected guidelines.
A comprehensive electronic literature search was conducted via six databases (PubMed, Medline, The Cochrane Library, Embase, CINAHL, and Web of Science), seven professional heart association websites, and nine guideline repositories. The Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument was adopted to critically appraise the methodological quality of the selected guidelines. Content analysis was used to summarise recommended self-managed non-pharmacological interventions for CVDs.
Twenty-three CPGs regarding different CVDs were included, in which four guidelines of CVDs, three for coronary heart diseases, seven for heart failure, two for atrial fibrillation, three for stroke, three for peripheral arterial disease, and one for hypertrophic cardiomyopathy. Twenty CPGs were appraised as high quality, and three CPGs as moderate quality. All twenty-three CPGs were recommended for use with or without modification. The domain of "Editorial Independence" had the highest standardized percentage (93.47%), whereas the domain of "Applicability" had the lowest mean domain score of 75.41%. The content analysis findings summarised some common self-managed non-pharmacological interventions, which include healthy diet, physical activity, smoking cessation, alcohol control, and weight management. Healthy diet and physical acidity are the most common and agreed on self-managed interventions for patients with CVDs. There are some inconsistencies identified in the details of recommended interventions, the intervention itself, the grade of recommendation, and the supported level of evidence.
The majority of the summarized non-pharmacological interventions were strongly recommended with moderate to high-quality levels of evidence. Healthcare professionals and researchers can adopt the results of this review to design self-managed non-pharmacological interventions for patients with CVDs.
心血管疾病（CVDs）是全球范围内的主要死因。通过优化管理不健康饮食和缺乏身体活动等风险因素，大多数与 CVD 相关的死亡是可以预防的。心血管疾病临床实践指南（CPGs）提供了一些基于证据的建议，有助于医疗保健专业人员为 CVD 患者提供最佳护理。本系统评价旨在系统评估 CPG 的方法学质量，并总结选定指南中针对 CVD 预防和管理的自我管理非药物干预措施的建议。
通过六个数据库（PubMed、Medline、The Cochrane Library、Embase、CINAHL 和 Web of Science）、七个专业心脏协会网站和九个指南库，进行全面的电子文献检索。采用指南研究与评估 II（AGREE II）工具对选定指南的方法学质量进行批判性评估。内容分析用于总结针对 CVD 的推荐自我管理非药物干预措施。
纳入了 23 项关于不同 CVD 的 CPG，其中 4 项 CVD 指南、3 项冠心病指南、7 项心力衰竭指南、2 项心房颤动指南、3 项中风指南、3 项外周动脉疾病指南和 1 项肥厚型心肌病指南。20 项 CPG 被评为高质量，3 项 CPG 为中等质量。所有 23 项 CPG 均被推荐使用或修改后使用。“编辑独立性”领域的标准化百分比最高（93.47%），而“适用性”领域的平均领域评分最低，为 75.41%。内容分析结果总结了一些常见的自我管理非药物干预措施，包括健康饮食、身体活动、戒烟、控制饮酒和体重管理。健康饮食和身体活动是 CVD 患者最常见和一致推荐的自我管理干预措施。在推荐干预措施的细节、干预本身、推荐等级和支持证据水平方面存在一些不一致。
总结的大多数非药物干预措施得到了强有力的推荐，具有中等到高度的证据质量。医疗保健专业人员和研究人员可以采用本综述的结果，为 CVD 患者设计自我管理非药物干预措施。
