数以百万计的人患有心血管疾病.1,2 Managing care for these patients can be complex since they have an increased risk of developing related complications and comorbidities such as 慢性肾病(CKD), heart failure (HF) 以及其他条件.3,4 Identifying risk factors and intervening early with a focus on lifestyle changes can help prevent cardiovascular diseases.1,5,6
预防心血管疾病和事件，同时管理风险因素
没有适当的风险管理和预防保健, 心血管疾病和相关事件的发生率可能会继续上升.1 Many risk factors contribute to this spike including an aging population and other interrelated health issues such as obesity, diabetes, 高血压和血脂异常(高胆固醇).1,5,7,8 Managing these risks early on, however, can help prevent or slow the onset of CV disease and events.9,10
心血管疾病及其相关疾病的一些危险因素，如 HF 不太知名的，包括 转甲状腺素介导的淀粉样变性.11 One subtype, 转甲状腺素淀粉样心肌病, occurs when a protein called transthyretin (ATTR) misfolds and builds up in the organs, 哪些会导致心力衰竭.11
Early detection and multidisciplinary care can manage symptoms and comorbidities1,5,6
Other physicians, 例如初级保健医生(pcp), 可以在心脏病专家之前看到有心血管疾病风险的患者吗, 因此，对心血管危险因素的教育和认识至关重要. 尽管预防是这些患者和临床医生的关键, 早期诊断是下一个最重要的步骤.12
After a diagnosis, coordinated care and communication between different clinicians can lead to safer, 以及更有效的病人护理.6,13 Coordination can include communicating and knowledge sharing between clinicians, 促进护理过渡, 制定前瞻性护理计划, monitoring follow-ups and connecting patients with the appropriate resources to help them adhere to their treatments and lifestyle changes.6,13 通过协调, healthcare professionals can help patients receive safer and more effective care to improve outcomes.6,13
Clinicians should also anticipate challenges their patients may face in following their care plans so they can help remove any barriers in the current healthcare environment. 坚持治疗的障碍可能包括文化信仰, 缺乏获得护理的机会, 健康教育程度低等等.13 如果临床医生预见到这些需求, they can work with their patients and identify other resources that can help set a strong foundation to ensure chronic care measures are in place to keep CV disease from progressing.13,14
心血管疾病需要急性和慢性护理方法
尽管人们努力及早发现心血管疾病或确定其危险因素, some patients can still slip through the cracks and may be treated or even diagnosed in an emergency setting.11 In these situations, patients’ treatment often takes an acute or emergency approach to stabilise patients in the short term before they’re referred to a cardiologist or other clinicians for chronic care.15-17
改善心血管病人的护理途径
Preventing CV disease and early detection are lifesaving interventions requiring a lifelong commitment from healthcare professionals across specialties. Coordinating care, 教育患者和临床医生, and addressing barriers to diagnosing CV disease can help prevent progression and improve outcomes for the millions affected by these conditions.18
At AstraZeneca, we’re committed to advancing the science to help protect people with CV disease and its related complications and comorbidities. We’re dedicated to increasing awareness and better understanding of CV disease among the complete spectrum of patients to reduce the risk of CV death and hospitalisation.
We continue to invest in the research and development to advance the science and bring forward innovative therapies to address CV patients’ unmet needs and eliminate this disease as a leading cause of death.
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References
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2. Mills, K. T., Stefanescu, A., & He, J. (2020). 高血压的全球流行病学. Nature reviews. 肾内科杂志，16(4)，223. http://doi.org/10.1038/s41581-019-0244-2
3. 概述-慢性肾脏疾病[互联网]. NHS Health A to Z. National Health Service; 2022 [cited 2023Feb14]. 可从:http://www获得.nhs.英国/条件/肾脏疾病/
4. 导致心力衰竭的原因? [Internet]. Heart Failure. American Heart Association; 2023 [cited 2023 Feb 14]. 可从:http://www获得.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure
5. Visseren FL, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M，等. 2021 ESC guidelines on Cardiovascular Disease Prevention in Clinical Practice. 欧洲心脏杂志. 2021;42(34):3227–337.
6. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11).
7. 张建军，张建军，张建军，等. 全球心血管疾病负担和风险. J Am Coll Cardiol. 2022年12月，80 (25)2361-2371. 可从:http://doi获得.org/10.1016/j.jacc.2022.11.005
8. 关于心脏病[互联网]. 疾病控制和预防中心. 疾病控制和预防中心; 2022 [cited 2023Feb14]. 可从:http://www获得.cdc.gov /心脏病.htm
9. Kottke, Thomas E. et al. The Comparative Effectiveness of Heart Disease Prevention and Treatment Strategies American Journal of Preventive Medicine, Volume 36, Issue 1, 82 - 88.e5
10. Rippe, J. M. (2019). Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease. 中国医学杂志，2013 (2)，204-212. http://doi.org/10.1177/1559827618812395
11. Rintell D, et al. Patient and family experience with transthyretin amyloid cardiomyopathy (ATTR-CM and polyneuropathy (ATTR-PN) amyloidosis: results of two focus groups. Orphanet J Rare Dis. 2021;16:7.v
12. Karunathilake, S. P., & Ganegoda, G. U. (2017). Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. 国际生物医学研究, 2018. http://doi.org/10.1155/2018/5767864
13. 护理协调〔互联网〕. AHRQ. Agency for Health Care Research and Quality; 2019 [cited 2023Feb14]. 可从:http://www获得.ahrq.gov / ncepcr /保健/协调.html
14. Kalantarzadeh M, Yousefi H, Alavi M, Maghsoudi J. Adherence barriers to treatment of patients with cardiovascular diseases: A qualitative study [Internet]. 伊朗护理和助产研究杂志. U.S. National Library of Medicine; 2022 [cited 2023Feb14]. 可从:http://www获得.ncbi.nlm.nih.gov / pmc /文章/ PMC9580571 /
15. Wójcik C, Shapiro MD. 弥合心脏病学和家庭医学之间的差距. Circulation. 2019年8月27日;140(9):709-711. doi: 10.1161/CIRCULATIONAHA.119.040151. Epub 2019 Aug 26. PMID: 31449452; PMCID: PMC6818419.
16. Soto, G.E., Huenefeldt, E.A., Hengst, M.N. et al. Implementation and impact analysis of a transitional care pathway for patients presenting to the emergency department with cardiac-related complaints. BMC Health service Res 18,672 (2018). 可从:http://doi获得.org/1
17. Zègre-Hemsey, J. K., Garvey, J. L., & Carey, M. G. (2016). 急诊科的心脏监测. 北美重症护理临床，28(3)，331. http://doi.org/10.1016/j.cnc.2016.04.009
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Veeva ID: Z4-52990
筹备日期:2023年3月