National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 1-Full Report
National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 1-Full Report
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DOI：
10.1016/j.jacl.2015.02.003
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发表时间：
2015-04-01
影响因子：
4.4
通讯作者：
Brown, W. Virgil
中科院分区：
文献类型：
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作者：
Jacobson, Terry A.;Ito, Matthew K.;Brown, W. Virgil
国家脂质协会的领导召集了一个专家小组，为临床医学中以患者为中心的血脂异常管理制定一套共识建议。以前曾发表过这些建议的执行摘要。本文件为执行摘要中概述的建议提供支持。主要结论包括：(1)循环载脂蛋白b脂蛋白（非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇[LDL-C]，称为致动脉粥样硬化胆固醇）携带的胆固醇水平升高是动脉粥样硬化的根本原因，是导致大多数临床动脉粥样硬化性心血管疾病（ASCVD）事件的关键潜在过程；(2)降低致动脉粥样硬化胆固醇升高水平将与致动脉粥样硬化胆固醇降低的程度成比例地降低ASCVD风险。这种益处被认为是通过多种方式降低动脉粥样硬化性胆固醇的结果，包括生活方式和药物治疗；(3)降低风险治疗的强度一般应根据患者发生ASCVD事件的绝对风险进行调整；(4)动脉粥样硬化是一个通常在生命早期开始的过程，在导致临床ASCVD事件之前发展数十年。因此，在评估降低风险疗法的潜在益处和危害时，应考虑中期、长期或终生风险；(5)对于指征降脂药物治疗的患者，他汀类药物治疗是降低ASCVD风险的主要方式；(6)非脂类ASCVD危险因素也应适当管理，特别是高血压、吸烟和糖尿病；(7)测量和监测致动脉粥样硬化胆固醇水平仍然是全面预防ASCVD策略的重要组成部分。(C) 2015年全国血脂协会。版权所有。
The leadership of the National Lipid Association convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. An Executive Summary of those recommendations was previously published. This document provides support for the recommendations outlined in the Executive Summary. The major conclusions include (1) an elevated level of cholesterol carried by circulating apolipoprotein B-containing lipoproteins (non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol [LDL-C], termed atherogenic cholesterol) is a root cause of atherosclerosis, the key underlying process contributing to most clinical atherosclerotic cardiovascular disease (ASCVD) events; (2) reducing elevated levels of atherogenic cholesterol will lower ASCVD risk in proportion to the extent that atherogenic cholesterol is reduced. This benefit is presumed to result from atherogenic cholesterol lowering through multiple modalities, including lifestyle and drug therapies; (3) the intensity of risk-reduction therapy should generally be adjusted to the patient's absolute risk for an ASCVD event; (4) atherosclerosis is a process that often begins early in life and progresses for decades before resulting a clinical ASCVD event. Therefore, both intermediate-term and long-term or lifetime risk should be considered when assessing the potential benefits and hazards of risk-reduction therapies; (5) for patients in whom lipid-lowering drug therapy is indicated, statin treatment is the primary modality for reducing ASCVD risk; (6) nonlipid ASCVD risk factors should also be managed appropriately, particularly high blood pressure, cigarette smoking, and diabetes mellitus; and (7) the measurement and monitoring of atherogenic cholesterol levels remain an important part of a comprehensive ASCVD prevention strategy. (C) 2015 National Lipid Association. All rights reserved.