Primary prevention of coronary heart disease - What has WOSCOPS told us and what questions remain?
Primary prevention of coronary heart disease - What has WOSCOPS told us and what questions remain?
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DOI：
10.2165/00003495-199754010-00001
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发表时间：
1997-07-01
期刊：
影响因子：
11.5
通讯作者：
Parekh, J
中科院分区：
文献类型：
--
作者：
Maher, V;Sinfuego, J;Parekh, J
在发达国家，冠心病仍然是死亡和发病的主要原因。因此，它的预防构成了一个重大的公共卫生挑战。最近，我们对这一疾病过程的了解有所扩大，许多影响其表达的因素已被阐明。此外，为了解决这个问题，已经进行了一些饮食和降脂药物的试验。这些研究表明，当血脂水平得到有利的改变时，心血管事件会减少，而不会产生不良影响。接受治疗和未接受治疗的患者之间的事件结局差异的比率取决于治疗前动脉粥样硬化的表现程度和血脂改变策略的积极程度。尽管如此，到目前为止，即使在这些试验中使用了最有效的降脂治疗，心血管事件的残余风险仍然高得令人无法接受。为了最大限度地减少未来事件的风险，需要更早的干预和更大程度的低密度脂蛋白和高密度脂蛋白水平的改变，并结合其他危险因素的修改。
Coronary heart disease remains the major cause of death and morbidity in developed countries. As a consequence, its prevention constitutes a significant public health challenge. In recent times, our understanding of this disease process has expanded and many of the factors that influence its expression have been elucidated. In addition, a number of trials of diet and lipid-lowering drugs have been performed in an effort to tackle this problem.These studies demonstrate that when lipid levels are favourably altered, cardiovascular events are reduced without adverse effect. The rate at which event outcomes diverge between treated and untreated patients depends on the degree of atherosclerosis manifestation prior to treatment and the aggressiveness of the lipid altering strategy. Nonetheless, to date, the residual risk of cardiovascular events is still unacceptably high despite even the most potent lipid-lowering treatments used in these trials. In order to minimise the risk of future events, earlier intervention and a greater change in LDL and HDL cholesterol levels are needed in conjunction with other risk factor modifications.