Reddy Koushik R, Freeman Andrew M
Division of Cardiology, Department of Medicine, James A. Haley VA Medical Center and University of South Florida, Tampa, FL, USA (KRR); and Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, USA (AMF).
Am J Lifestyle Med. 2022 Oct 3;18(2):216-232. doi: 10.1177/15598276221130684. eCollection 2024 Mar-Apr.
Despite numerous advances in basic understanding of cardiovascular disease pathophysiology, pharmacology, therapeutic procedures, and systems improvement, there hasn't been much decline in heart disease related mortality in the US since 2010. Hypertension and diet induced risk continue to be the leading causes of cardiovascular morbidity. Even with the excessive mortality associated with the COVID-19 pandemic, in 2020, heart disease remained the leading cause of death. Given the degree of disease burden, morbidity, and mortality, there is an urgent need to redirect medical professionals' focus towards prevention through simple and cost effective lifestyle strategies. However, current practice paradigm and financial compensation systems are mainly centered disease management and not health promotion. For example, the financial value placed on 3-10 min smoking cessation counseling (.24RVUs) is 47-fold lower than an elective PCI (11.21 RVUs). The medical community seems to be enamored with the latest and greatest technology, new devices, and surgical procedures. What if the greatest technology of all was simply the way we live every day? Perhaps when this notion is known by enough, we will switch to this lifestyle medicine technology to prevent disease in the first place.
尽管在心血管疾病病理生理学、药理学、治疗程序以及系统改进的基础认知方面取得了诸多进展,但自2010年以来,美国心脏病相关死亡率并未出现大幅下降。高血压和饮食引发的风险仍是心血管疾病发病的主要原因。即便存在与新冠疫情相关的过高死亡率,在2020年,心脏病仍是首要死因。鉴于疾病负担、发病率和死亡率的程度,迫切需要将医疗专业人员的重点通过简单且具成本效益的生活方式策略转向预防。然而,当前的实践模式和经济补偿体系主要集中在疾病管理而非健康促进。例如,给予3至10分钟戒烟咨询的经济价值(0.24相对价值单位)比选择性经皮冠状动脉介入治疗(11.21相对价值单位)低47倍。医学界似乎痴迷于最新、最先进的技术、新设备和外科手术。要是所有最伟大的技术仅仅是我们每天的生活方式呢?或许当足够多的人了解这一观念时,我们会首先转向这种生活方式医学技术来预防疾病。