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CARDIOLOGY

Academician Gu Dongfeng: Cardiovascular and Cerebrovascular Disease Risk and Individualized Prevention

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The situation of cardiovascular disease in China is severe 1. Cardiovascular and cerebrovascular disease is the leading cause of death and disease burden in China. In 2017, there were 1.75 million deaths from coronary heart disease and 2.11 million deaths from stroke.The medical expenses related to the hospitalization and treatment of cardiovascular diseases have surged. Data show that in 2016 alone, the total cardiovascular hospitalization costs in China exceeded 104.6 billion, an increase of 13% compared to 2015.The 2013 map of China ’s cardiovascular and cerebrovascular diseases by province ’s standardized mortality distribution map shows that China ’s cardiovascular and cerebrovascular diseases have a significantly higher mortality rate in northern regions and the Qinghai-Tibet Plateau than in other regions, with Tibet having the highest rate (476.8 cases per 100,000 people);Regions and Sichuan regions are relatively low, of which Hong Kong is the lowest in the country (140.2 cases per 100,000 people).2. Need to strengthen the management of cardiovascular disease risk factors Cardiovascular disease risk factors mainly include hypertension, diabetes, dyslipidemia, obesity, smoking (active / passive), harmful drinking, lack of exercise, etc.According to statistics, the control of risk factors in the Chinese population is not satisfactory. The prevalence of hypertension has increased year by year (5.1% in 1959 and 23.2% in 2012), and the prevalence of diabetes has increased year by year (0.8% in 1980)., 10.9% in 2013), a high proportion of dyslipidemia (40.4%), a rapid increase in the number of obese (2.4 million in 1975, and 8.96 million in 2014), and a high proportion of active and passive smoking (52.9% of men and females2.4% had active smoking habits; the proportion of passive smoking was as high as 72.4%). The harmful drinking rate was 9.3% among drinkers, and only 18.7% were among those who exercised regularly.According to forecast data of strokes and coronary heart disease events in Chinese adults aged 35-84 years from 2010 to 2030, even if the prevalence of risk factors remains the same, population growth and aging will continue to increase the incidence of cardiovascular disease.3. Diabetes Aggravates the Burden of Cardiovascular Disease Studies in the Chinese population have shown that diabetes significantly increases the risk of arteriosclerotic cardiovascular disease (ASCVD), and impaired fasting blood glucose may also be associated with an increased risk of ASCVD.In addition, diabetes also increases the risk of stroke and coronary heart disease, and the harm to coronary heart disease is higher than stroke.Promote cardiovascular disease risk assessment and promote accurate prevention and management Under such a severe situation, it is particularly important to carry out cardiovascular disease risk assessment and promote accurate prevention and management.Risk assessment is the basis for cardiovascular prevention and control at the individual level. The “China Cardiovascular Disease Risk Assessment and Management Guide” emphasizes the use of risk assessment models suitable for Chinese people, and focuses on maintaining a variety of healthy lifestyles and promoting active health concepts.Promotion.Development of a risk prediction model for ASCVD risk in the Chinese population: The total sample size of the China-PAR cohort study was 127,000, and the longest follow-up period was 23 years. Based on the traditional factors such as age, blood pressure, and smoking, the region, waist circumference, heartThe family history of vascular diseases and other variables have introduced a risk assessment model suitable for the Chinese, and it has been confirmed that the 10-year cardiovascular disease risk prediction effect is better than that in Europe and the United States.The above study summarized 7 cardiovascular health (CVH) indicators, including fasting blood glucose, total cholesterol, blood pressure, smoking, healthy diet scores, body mass index, and physical activity, and found that 62.1% of ASCVD incidence and failure to reach 7 ideal CVHIndicators, and only maintaining the ideal blood pressure, can reduce the incidence of ASCVD by 44.1%, and the more the number of ideal CVH indicators, the lower the risk of ASCVD.Academician Gu Dongfeng pointed out that popularizing and strengthening the publicity and education of ideal CVH indicators is very important to create and promote a healthy social environment.The report of the 19th National Congress of October 2017 clearly stated that “people’s health is an important symbol of national prosperity and national prosperity.” On July 18, 2019, the “Healthy China Action” was officially launched, and the “Action” mapped out the strategy of a healthy China. “”Roadmap”, thematic deployment of the implementation of cardiovascular disease prevention and prevention of diabetes. Of the 15 special actions organized in 3 major categories, 11 of them are closely related to the prevention and control of cardiovascular and cerebrovascular diseases.1. Defining the goals of diabetes prevention and control and the corresponding measures: The goals of diabetes awareness rate and standardized management rate are clearly set, and the treatment rate, control rate, and complication screening rate are steadily increased.The diabetes awareness rate is required to increase from 36.1% in 2012 to 50% by 2022, while the target in 2030 is 60%.In 2022, the standardized management rate of diabetes will increase from 50% in 2015 to 60%, and the target in 2030 is 70%.Corresponding measures: Provide standardized health management services for diabetic patients, implement graded diagnosis and treatment technical specifications, guide patients in self-monitoring blood glucose and health management, promote the standardization of diabetes screening, provide targeted health education to high-risk groups, and promote “Internet +”Public health”, innovative diabetes health management methods.2. Define the cardiovascular disease prevention and control goals and response measures: The cardiovascular death rate will be reduced from 298.4 cases per 100,000 people (rural) and 264.8 cases per 100,000 people (rural) in 2015 to 209.7 cases in 2022.100,000 people, the target for 2030 is 190.7 cases per 100,000 people.Corresponding measures: Guide residents to learn and master self-help and mutual rescue knowledge and skills such as cardiopulmonary resuscitation, and provide lifestyle guidance to high-risk groups and patients.Fully implement the blood pressure measurement system for the first diagnosis of people over 35 years old, strengthen the standardized management of hypertension, hyperglycemia, and dyslipidemia, and improve pre-hospital emergency and emergency treatment capabilities..
Academician Gu Dongfeng concluded that the epidemic trend of cardiovascular disease in China is still severe, and the “Healthy China Action” is a concrete way to achieve the “Healthy China Strategy”. Cardiovascular risk assessment is an important part of individualized prevention of cardiovascular disease.Cardiovascular health indicators have important prevention and treatment significance. Combining cardiovascular whole-genome risk assessment with traditional risk assessment will promote individualized and accurate prevention and management.The above content is only authorized by 39Health.com for exclusive use, please do not reprint without authorization of the copyright party.

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