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首页> 外文期刊>The European journal of general practice. >Conflicts and dilemmas in prevention of cardiovascular disease. the new, Norwegian Guidelines-a new approach to risk management
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Conflicts and dilemmas in prevention of cardiovascular disease. the new, Norwegian Guidelines-a new approach to risk management

机译：预防心血管疾病的矛盾与困境。挪威新准则-一种新的风险管理方法

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摘要

Prevention of cardiovascular disease (CVD) has been debated for many years, between an organ-specialist perspective versus a public health view. As an illustration, the Wonca Europe Council decided in 2004 to withdraw its support to the 2003 European Guidelines. This paper discusses the main sources of disagreement, most important the levels of risk when treatment should be offered. The Norwegian Guideline for primary prevention of CVD (2009) introduced a new principle of age-differentiated risk levels. Pharmacological treatment should be offered to all persons aged 40-49 years with 10-year mortality risk ≥ 1%, all persons aged 50-59 years at ≥ 5% risk, and all persons aged 6069 years at ≥ 10% risk. Lower thresholds for younger persons are based on the fact that life years lost, will be considerable if drugs are prescribed only for risk levels above 5%. For persons aged 60-69 years, age is the dominant risk factor and the benefits of treatment are smaller. The implications of the recommendation are discussed, both at an individual and a societal level. Compared to the European 2007 guidelines, the total sum of life years gained is about the same, but the number of patients treated is considerably lower.
机译：预防心血管疾病（CVD）在器官专科医生的观点与公共卫生的观点之间已经争论了很多年。例如，旺卡欧洲理事会（Wonca Europe Council）在2004年决定撤回对2003年欧洲指南的支持。本文讨论了分歧的主要根源，最重要的是应提供治疗时的风险水平。挪威CVD初级预防指南（2009）引入了年龄差异风险水平的新原则。应为所有40-49岁，10年死亡率风险≥1％的人，所有50-59岁，风险≥5％的人以及6069岁风险在10％以上的人提供药理治疗。降低青年人的门槛是基于这样的事实，即如果仅针对风险水平高于5％的人开药，那么生命就将流失。对于60-69岁的人，年龄是主要的危险因素，治疗的收益较小。该建议的含义已在个人和社会层面上进行了讨论。与欧洲2007年指南相比，所获得的生命年总数大致相同，但是所治疗的患者数量却要低得多。

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