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首页> 外文期刊>Journal of the American Academy of Nurse Practitioners. >Preventing coronary heart disease and stroke with aggressive statin therapy in older adults using a team management model.
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Preventing coronary heart disease and stroke with aggressive statin therapy in older adults using a team management model.

机译：使用团队管理模型在老年人中采用积极的他汀类药物疗法预防冠心病和中风。

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PURPOSES: The purposes of this review were to highlight recent clinical trial results on the safety and efficacy of statin therapy in adults aged 65 years and older and to examine how nurse practitioners (NPs) and physician assistants (PAs) working together with physicians as a team can better serve the needs of this fastest growing subset of the U.S. population who are at high risk for cardiovascular events including stroke. DATA SOURCES: This report was compiled by reviewing the scientific literature on the safety and efficacy of statin therapy, including effects on cardiovascular, coronary, and stroke endpoints, with particular reference to clinical trial results in older patients. CONCLUSIONS: Recent guidelines emphasize that age alone is not a reason to withhold treatment with statin therapy in older adults. However, despite the evidence highlighted in this review demonstrating that older patients can safely achieve substantial benefit from statin therapy, studies have consistently shown an inverse relationship between age and treatment propensity. Often, older patients have multiple risk factors and many chronic comorbid conditions that seem to complicate and hinder treatment in many busy clinic practices. More extensive guidelines for the use of statin therapy in older patients, incorporating recommendations for treatment targets and developing a framework for the use of statins in stroke prevention, would assist care providers in the management of this high-risk population. Finally, NPs and PAs are both well educated and well placed to manage patients with chronic stable cardiovascular disease (CVD). IMPLICATIONS FOR PRACTICE: The implementation of a multidisciplinary team approach to identify at-risk individuals and provide them with education, counseling, and effective statin treatment will aid efforts to reduce the increased risk for morbidity and mortality associated with CVD in older adults.
机译：目的：本综述的目的是强调有关他汀类药物在65岁及以上成年人中的安全性和有效性的最新临床试验结果，并探讨护理从业人员（NPs）和医师助理（PAs）如何与医师一起工作。研究小组可以更好地满足这一人口增长最快的美国人群的需求，他们是心血管疾病（包括中风）高风险人群。数据来源：本报告是通过回顾有关他汀类药物治疗的安全性和有效性的科学文献而编写的，包括对心血管，冠状动脉和中风终点的影响，特别是针对老年患者的临床试验结果。结论：最近的指南强调仅凭年龄并不是拒绝接受他汀类药物治疗的原因。然而，尽管本综述强调了证据，表明老年患者可以安全地从他汀类药物治疗中获益，但研究始终显示年龄与治疗倾向之间存在反比关系。通常，老年患者有多种危险因素和许多慢性合并症，在许多繁忙的临床实践中似乎使治疗变得复杂并阻碍了治疗。在老年患者中使用他汀类药物治疗的更广泛的指南，结合治疗目标的建议并开发在中风预防中使用他汀类药物的框架，将有助于护理提供者管理这一高危人群。最后，NPs和PAs都受过良好的教育，并且位置优越，可以治疗患有慢性稳定性心血管疾病（CVD）的患者。实践的意义：实施多学科团队方法以识别高危人群，并为他们提供教育，咨询和有效的他汀类药物治疗，将有助于降低老年人与CVD相关的发病率和死亡率风险的增加。

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