用于成年人心血管疾病的初级预防:美国预防服务工作组建议声明

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Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles

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, Kirsten Bibbins-Domingo¹, David C Grossman²

¹University of California, San Francisco.

JAMA

|November 14, 2016

概括

美国预防服务工作组 (USPSTF) 建议40至75岁的成年人服用他类药物,其心血管疾病风险因素和10年风险为10%. 对于那些有7.5%风险的人来说,建议选择性提供.

科学领域:

预防医学
心脏病学
公共卫生

背景情况:

心血管疾病 (CVD) 是美国的主要死亡原因.
目前的指导方针需要更新关于脂质查和他类药物的使用.
在没有先前心血管疾病事件的成年人中,关于他类药物的益处和危害的证据需要审查.

研究的目的:

更新2008年USPSTF关于查脂质疾病的建议.
评估他类药物治疗对心血管疾病的初级预防的益处和危害.
评估不同成年人亚组和风险水平的他疗效.

主要方法:

对查失脂症的证据进行系统审查.
在未患有心血管疾病的成年人中分析使用他的益处和危害.
对他类药物的有效性和最佳治疗策略的研究.

主要成果:

建议使用低剂量至中剂量的他类药物,适用于40至75岁的患有心血管疾病风险因素的成年人,且10年内心血管疾病风险≥10% (B建议).
临床医生应选择性地为40至75岁的患有心血管疾病风险因素的成年人提供他类药物,并且10年内心血管疾病风险为7.5%至10% (C建议).
没有足够的证据推在76岁及以上的成年人服用他类药物 (I声明).

结论:

更新的建议为初级心血管疾病预防提供了关于使用他类药物的指导.
风险分层对于确定使用他类药物治疗的成年人来说至关重要.
需要对老年人进行进一步的研究和具体的治疗策略.

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