对于胆固醇风险因素查的国家指南的影响. 弗雷明汉姆后代研究
P W Wilson1, J C Christiansen, K M Anderson
1Framingham Heart Study, MA 01701.
JAMA
|July 7, 1989
概括
新的胆固醇指南显示,50%的胆固醇含量达到理想水平. 饮食是控制胆固醇的关键,特别是40-60岁的成年人,可能减少药物需求.
科学领域:
- 心血管健康 心血管健康
- 预防性心脏病学 预防性心脏病学
- 脂质代谢 脂质代谢是什么
背景情况:
- 国家胆固醇教育计划 (NCEP) 最近更新了对胆固醇管理的指南.
- 评估这些指南对大群体的适用性对于公共卫生至关重要.
- 了解不同人群中的脂质特征和冠状动脉风险,可以为预防策略提供信息.
研究的目的:
- 根据NCEP指南,评估30-69岁成年人中理想,边缘和升高胆固醇水平的患病率.
- 预测饮食干预对低密度脂蛋白胆固醇 (LDL-C) 和随后的降脂药物使用的潜在影响.
- 在Framingham Offspring研究中,评估基于NCEP的冠状动脉风险算法的不同年龄和性别组的特异性.
主要方法:
- 分析了792名男性和853名女性 (年龄在30-69岁) 的脂质资料,这些脂质来自于"弗雷明汉子女研究" (1983-1987).
- 应用NCEP推的算法来对胆固醇水平进行分类 (理想,边界,升高).
- 对预计的药物使用率和冠状动脉风险算法特异性的评估对饮食影响 (5%,10%,20%的LDL-C降低) 的建模.
主要成果:
- 50%的参与者具有理想的胆固醇水平,12%的男性和30%的女性具有边界水平,35%的男性和19%的女性具有升高水平.
- 饮食干预措施将LDL-C降低5%,10%或20%,可以将脂质药物需求分别降低到10%,5%或2%.
- NCEP冠状动脉风险算法显示,40岁以下的女性和60岁以上的男性和女性的特异性降低.
结论:
- 饮食修改可能是满足当前胆固醇指南的主要策略.
- 年龄在40-60岁之间的个人可能会从遵守这些指南中获得最显著的好处.
- 对于特定的人口群体,特别是年轻女性和老年人来说,可能需要对风险评估算法进行改进.
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