美国心脏病协会(Aha)和美国心脏病学学会(Acc)发表了冠
&nbps;&nbps;&nbps;&nbps;WESTPORT, CT (Reuters Health) - The American Heart Association (AHA) and the American College of Cardiology (ACC) have issued a consensus statement regarding risk reduction strategies for patients with coronary and other atherosclerotic vascular disease.
&nbps;&nbps;&nbps;&nbps;Since a statement regarding secondary prevention was last issued in 1995, evidence has accrued showing that "use of beta-blockers should no longer be limited to patients who have suffered a myocardial infarction, but should be expanded to coronary disease patients," Dr. Noel Bairey Merz, chair of the ACC's prevention committee, told Reuters Health.
, 百拇医药
&nbps;&nbps;&nbps;&nbps;Similarly, ACE inhibitors are now indicated for patients with atherosclerosis, not just those with hypertension and congestive heart failure, she said.
&nbps;&nbps;&nbps;&nbps;The AHA/ACC have revised their guidelines regarding hormone replacement therapy in women with established heart disease, because several trials have demonstrated no benefit in this situation.
&nbps;&nbps;&nbps;&nbps;"We also place much more emphasis on exercise," said Dr. Bairey Merz, who is director of the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center in Los Angeles. "It's the physician's job to really push for daily physical activity in these patients."
, 百拇医药
&nbps;&nbps;&nbps;&nbps;In its statement, the consensus panel notes that many patients for whom therapies are indicated go untreated. Dr. Bairey Merz pointed out that fewer than half of appropriate patients are being treated with lipid-lowering drugs, while the use of beta-blockers is little better.
&nbps;&nbps;&nbps;&nbps;"We really are arming and challenging physicians to rise to this evidence," she said. "They need to call their patients back in, re-evaluate them, and get them on the right drugs."
, 百拇医药
&nbps;&nbps;&nbps;&nbps;While cost can be an issue, the doctor noted that many beta-blockers are available in generic versions, and that a lipid-lowering agent was recently approved for generic status. "So we are starting to get into monthly costs that are like having a Starbucks coffee every day," she pointed out.
&nbps;&nbps;&nbps;&nbps;Besides, she asked, "Do you want to spend money on ambulances, intensive care units and bypass surgery, or do you want to spend your money on prevention? Ten years of a cholesterol-lowering drug is still less expensive than bypass surgery, so all you have to do is avoid a few in 100 patients and you're paying for the drug.", 百拇医药
&nbps;&nbps;&nbps;&nbps;Since a statement regarding secondary prevention was last issued in 1995, evidence has accrued showing that "use of beta-blockers should no longer be limited to patients who have suffered a myocardial infarction, but should be expanded to coronary disease patients," Dr. Noel Bairey Merz, chair of the ACC's prevention committee, told Reuters Health.
, 百拇医药
&nbps;&nbps;&nbps;&nbps;Similarly, ACE inhibitors are now indicated for patients with atherosclerosis, not just those with hypertension and congestive heart failure, she said.
&nbps;&nbps;&nbps;&nbps;The AHA/ACC have revised their guidelines regarding hormone replacement therapy in women with established heart disease, because several trials have demonstrated no benefit in this situation.
&nbps;&nbps;&nbps;&nbps;"We also place much more emphasis on exercise," said Dr. Bairey Merz, who is director of the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center in Los Angeles. "It's the physician's job to really push for daily physical activity in these patients."
, 百拇医药
&nbps;&nbps;&nbps;&nbps;In its statement, the consensus panel notes that many patients for whom therapies are indicated go untreated. Dr. Bairey Merz pointed out that fewer than half of appropriate patients are being treated with lipid-lowering drugs, while the use of beta-blockers is little better.
&nbps;&nbps;&nbps;&nbps;"We really are arming and challenging physicians to rise to this evidence," she said. "They need to call their patients back in, re-evaluate them, and get them on the right drugs."
, 百拇医药
&nbps;&nbps;&nbps;&nbps;While cost can be an issue, the doctor noted that many beta-blockers are available in generic versions, and that a lipid-lowering agent was recently approved for generic status. "So we are starting to get into monthly costs that are like having a Starbucks coffee every day," she pointed out.
&nbps;&nbps;&nbps;&nbps;Besides, she asked, "Do you want to spend money on ambulances, intensive care units and bypass surgery, or do you want to spend your money on prevention? Ten years of a cholesterol-lowering drug is still less expensive than bypass surgery, so all you have to do is avoid a few in 100 patients and you're paying for the drug.", 百拇医药