Heart and Lung Center, Cardiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Raisio Group plc, Raisio, Finland.
Lipids Health Dis. 2024 Oct 21;23(1):341. doi: 10.1186/s12944-024-02330-7.
The risk of atherosclerotic cardiovascular diseases (ASCVDs) can be reduced by lowering low-density lipoprotein cholesterol (LDL-C) concentrations. Nevertheless, ASCVDs still cause most deaths worldwide. Here, we discuss the prevention of ASCVD and the event risk with a focus on heart-healthy diets, i.e., low intakes of saturated and trans-fatty acids and cholesterol, and high intakes of unsaturated fatty acids, viscous fibre, and dietary phytostanols as fatty acid esters, according to international dyslipidaemia treatment guidelines. Calculations based on both FINRISK and Cholesterol Treatment Trialists' Collaborators regression equations indicate that heart-healthy diets combined with phytostanol ester reduce LDL-C concentrations to such an extent that the 10-year estimated reduction in the incidence of coronary artery disease would be 23%. This information can be used, in particular, to prevent the development of subclinical atherosclerosis in healthy middle-aged populations and the progression of atherosclerosis to ASCVD. The outcome of simple and feasible dietary changes, and, when needed, combined with statins, can be significant: reduced mortality, an increased number of healthy life-years, and reduced healthcare costs.
降低低密度脂蛋白胆固醇（LDL-C）浓度可以降低动脉粥样硬化性心血管疾病（ASCVD）的风险。然而，ASCVD 仍然是全球大多数死亡的原因。在这里，我们根据国际血脂异常治疗指南，讨论 ASCVD 的预防和事件风险，重点是心脏健康的饮食，即低饱和脂肪和反式脂肪以及胆固醇的摄入量，以及高不饱和脂肪酸、粘性纤维和植物甾烷醇作为脂肪酸酯的摄入量。基于 FINDRISK 和胆固醇治疗试验者合作组回归方程的计算表明，心脏健康的饮食结合植物甾烷醇酯可将 LDL-C 浓度降低到足以使冠心病 10 年估计发病率降低 23%的程度。这些信息尤其可用于预防健康中年人群亚临床动脉粥样硬化的发展以及动脉粥样硬化向 ASCVD 的进展。简单可行的饮食改变的结果，以及在需要时与他汀类药物联合使用，可以显著降低死亡率、增加健康寿命年数和降低医疗保健成本。
