Apple Samuel J, Clark Rachel, Daich Jonathan, Gonzalez Macarena Lopez, Ostfeld Robert J, Toth Peter P, Bittner Vera, Martin Seth S, Rana Jamal S, Nasir Khurram, Shapiro Michael D, Virani Salim S, Slipczuk Leandro
Department of Medicine, New York City Health and Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA.
Rev Cardiovasc Med. 2023 Dec 13;24(12):350. doi: 10.31083/j.rcm2412350. eCollection 2023 Dec.
Although great progress has been made in the diagnostic and treatment options for dyslipidemias, unawareness, underdiagnosis and undertreatment of these disorders remain a significant global health concern. Growth in digital applications and newer models of care provide novel tools to improve the management of chronic conditions such as dyslipidemia. In this review, we discuss the evolving landscape of lipid management in the 21st century, current treatment gaps and possible solutions through digital health and new models of care. Our discussion begins with the history and development of value-based care and the national establishment of quality metrics for various chronic conditions. These concepts on the level of healthcare policy not only inform reimbursements but also define the standard of care. Next, we consider the advances in atherosclerotic cardiovascular disease risk score calculators as well as evolving imaging modalities. The impact and growth of digital health, ranging from telehealth visits to online platforms and mobile applications, will also be explored. We then evaluate the ways in which machine learning and artificial intelligence-driven algorithms are being utilized to address gaps in lipid management. From an organizational perspective, we trace the redesign of medical practices to incorporate a multidisciplinary team model of care, recognizing that atherosclerotic cardiovascular disease risk is multifaceted and requires a comprehensive approach. Finally, we anticipate the future of dyslipidemia management, assessing the many ways in which atherosclerotic cardiovascular disease burden can be reduced on a population-wide scale.
尽管在血脂异常的诊断和治疗选择方面已经取得了很大进展，但这些疾病的未被认识、诊断不足和治疗不足仍然是一个重大的全球健康问题。数字应用的发展和新型护理模式提供了新的工具，以改善对血脂异常等慢性病的管理。在这篇综述中，我们讨论了21世纪血脂管理的不断变化的格局、当前的治疗差距以及通过数字健康和新型护理模式可能的解决方案。我们的讨论从基于价值的护理的历史和发展以及国家为各种慢性病建立质量指标开始。这些医疗保健政策层面的概念不仅为报销提供依据，也定义了护理标准。接下来，我们考虑动脉粥样硬化性心血管疾病风险评分计算器的进展以及不断发展的成像方式。还将探讨数字健康的影响和发展，从远程医疗就诊到在线平台和移动应用程序。然后，我们评估机器学习和人工智能驱动的算法被用于解决血脂管理差距的方式。从组织角度来看，我们追溯医疗实践的重新设计，以纳入多学科护理团队模式，认识到动脉粥样硬化性心血管疾病风险是多方面的，需要综合方法。最后，我们预测血脂异常管理的未来，评估在人群范围内可以降低动脉粥样硬化性心血管疾病负担的多种方式。
