非HDL胆固醇用于基于人群的心血管风险分层:多国心血管风险联盟的结果
Fabian J Brunner1, Christoph Waldeyer1, Francisco Ojeda1
1University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany.
Lancet (London, England)
|December 8, 2019
概括
高非HDL胆固醇显著增加了长期心血管疾病的风险. 早期的降脂治疗可以大大降低这种风险,有助于初级预防策略.
科学领域:
- 心脏病学
- 公共卫生
- 生物统计学
背景情况:
- 血脂水平与心血管疾病 (CVD) 发病率之间的联系以及降脂疗法的影响需要进一步阐明.
- 研究非高密度脂蛋白 (非HDL) 胆固醇度的全谱对于了解心血管疾病风险至关重要.
研究的目的:
- 评估与各种非HDL胆固醇水平相关的心血管疾病风险.
- 开发一种工具来估计长期心血管疾病的发生概率和降脂治疗的风险降低.
主要方法:
- 使用了来自19个国家的多国心血管风险联盟的数据.
- 使用非HDL胆固醇类别的欧洲指导值进行性别特异的多变量分析.
- 在75岁时开发并验证了心血管疾病事件的风险预测工具,模拟非HDL胆固醇的50%降低.
主要成果:
- 在男性和女性中,随着非HDL胆固醇类别的增加,观察到30年内心血管疾病发病率逐渐上升.
- 非HDL胆固醇度的升高与心血管疾病风险的增加有显著关联 (HRs 范围为1. 1至2. 3).
- 开发的工具在预测心血管疾病发生概率和模拟风险降低方面表现出很高的准确性.
结论:
- 血液中的非HDL胆固醇度与长期动脉样硬化心血管疾病风险密切相关.
- 提供了一个简单的工具,用于个人风险评估,并说明早期降脂干预措施的好处.
- 这些发现支持医生与患者之间关于心血管疾病初级预防策略的交流.
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