Grundy S M
Department of Clinical Nutrition, University of Texas Southwestern Medical Center at Dallas, USA.
Arch Intern Med. 1997 Jun 9;157(11):1177-84.
Recent clinical trials have demonstrated that reductions of serum low-density lipoprotein (LDL) levels substantially decrease the risk for coronary heart disease. These trials confirm other lines of evidence that high levels of LDL are a critical atherogenic factor. Aggressive lowering of LDL levels in high-risk patients promises to significantly reduce morbidity and mortality from coronary heart disease in the first third of the 21st century. However, several additional measures will be required to marginalize coronary heart disease in the 21st century. Other lipoprotein abnormalities and other risk factors, eg, cigarette smoking, hypertension, and diabetes mellitus, must be controlled to obtain the full benefit of LDL-lowering therapy. Moreover, the health care delivery system must be reorganized to put more emphasis on prevention. Although much can be achieved through application of current knowledge in prevention efforts, further advances through new research will be required to remove coronary heart disease as a major cause of death in the United States.
近期的临床试验表明，降低血清低密度脂蛋白（LDL）水平可大幅降低冠心病风险。这些试验证实了其他证据，即高水平的LDL是一个关键的致动脉粥样硬化因素。在高危患者中积极降低LDL水平有望在21世纪的前三分之一时间内显著降低冠心病的发病率和死亡率。然而，在21世纪要将冠心病边缘化还需要采取其他一些措施。必须控制其他脂蛋白异常和其他危险因素，如吸烟、高血压和糖尿病，以充分受益于降低LDL的治疗。此外，必须重组医疗保健提供系统，更加重视预防。尽管通过在预防工作中应用现有知识可以取得很大成就，但仍需要通过新的研究取得进一步进展，以消除冠心病作为美国主要死因的地位。
