基于美国预防服务工作组建议与ACC/AHA指南的初级预防类药物治疗的推资格的比较
Neha J Pagidipati1, Ann Marie Navar1, Hillary Mulder1
1Duke Clinical Research Institute, Duke University, Durham, North Carolina.
JAMA
|April 19, 2017
概括
与较旧的ACC/AHA指南相比,美国对初级预防中他类药物治疗的新指南可能会建议较少的人接受治疗. 这可能会影响心血管疾病高风险的年轻人.
科学领域:
- 心血管医学
- 预防性心脏病学
- 公共卫生指南
背景情况:
- 在初级预防中对他类药物治疗的指导建议显示出显著的差异.
- 美国预防服务特别工作组 (USPSTF) 现在强调基于心血管疾病 (CVD) 风险因素的治疗和10%或更高的10年全球心血管疾病风险.
研究的目的:
- 根据2016年USPSTF建议与2013年美国心脏病学会/美国心脏协会 (ACC/AHA) 准则,比较美国成年人的初级预防性他类药物治疗资格.
主要方法:
- 采用国家健康和营养检查调查 (NHANES) 的数据 (2009-2014) 来自3416名年龄在40至75岁的美国成年人的全国代表样本.
- 根据2016年USPSTF建议和2013年ACC/AHA胆固醇指南评估他类药物的适用性,不包括以前患有心血管疾病的人.
主要成果:
- 完全执行USPSTF建议将导致额外的15. 8%的患者开始服用他类药物,而根据ACC/ AHA指南,这一比例为24. 3%.
- 一个值得注意的群体 (8.9%) 是ACC/AHA推的,但USPSTF不推的,包括具有高长期心血管疾病风险的年轻人 (40-59岁) 和糖尿病患者.
结论:
- 与2013年ACC/AHA指南相比,2016年USPSTF的建议可能会导致较少的人被推接受初级预防性他类药物治疗.
- 这种推的差异可能特别影响具有长期心血管风险的年轻人.
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