2013ACC/AHA心血管病风险评估指南:美国心脏病学会/美国心脏协会专责组实践指南报告2013ACC/AHAGuidelineontheAssessmentofCardiovascularRisk:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonPracticeGuidelinesDavidC.Goff,Jr,DonaldM.Lloyd-Jones,GlenBennett,SeanCoady,RalphB.D'Agostino,Sr,RaymondGibbons,PhilipGreenland,DanielT.Lackland,DanielLevy,ChristopherJ.O'Donnell,JenniferRobinson,J.SanfordSchwartz,SusanT.Shero,SidneyC.Smith,Jr,PaulSorlie,NeilJ.StoneandPeterW.F.WilsonCirculationpublishedonlineNovember12,2013;Circulation.ispublishedbytheAmericanHeartAssociation,7272GreenvilleAvenue,Dallas,TX75231Copyright©2013AmericanHeartAssociation,Inc.Allrightsreserved.PrintISSN:0009-7322.OnlineISSN:1524-4539本文网上版及更新信息和服务,位于互联网:PDF文件使用pdfFactoryPro试用版本创建数据补充(未经编辑)位于:心血管病风险评估指南美国心脏病学会/美国心脏协会专责组实践指南报告美国心肺康复协会(AmericanAssociationofCardiovascularandPulmonaryRehabilitation),美国预防心脏病协会(AmericanSocietyforPreventiveCardiology),美国高血压协会(AmericanSocietyofHypertension),黑人心脏病医生协会(AssociationofBlackCardiologists),全国血脂协会(NationalLipidAssociation),预防心血管护士协会(PreventiveCardiovascularNursesAssociation)和妇女心脏(WomenHeart):全国妇女心脏病联合会(TheNationalCoalitionforWomenwithHeartDisease)认可专家工作组成员DavidC.Goff,Jr,MD,PhD,FACP,FAHA,Co-ChairDonaldM.Lloyd-Jones,MD,ScM,FACC,FAHA,Co-ChairGlenBennett,MPH*ChristopherJ.O’Donnell,MD,MPH*SeanCoady,MS*JenniferRobinson,MD,MPH,FAHARalphB.D’Agostino,Sr,PhD,FAHAJ.SanfordSchwartz,MDRaymondGibbons,MD,FACC,FAHASusanT.Shero,MS,RN*PhilipGreenland,MD,FACC,FAHASidneyC.Smith,Jr,MD,FACC,PDF文件使用pdfFactoryPro试用版本创建*DanielLevy,MD*NeilJ.Stone,MD,FACC,FAHAPeterW.F.Wilson,MD,FAHA方法学成员HarmonS.Jordan,ScDLevNevo,MDJanuszWnek,PhDACCF/AHA专责组成员JeffreyL.Anderson,MD,FACC,FAHA,ChairJonathanL.Halperin,MD,FACC,FAHA,Chair-ElectNancyM.Albert,PhD,CCNS,CCRN,FAHAJudithS.Hochman,MD,FACC,FAHABiykemBozkurt,MD,PhD,FACC,FAHARichardJ.Kovacs,MD,FACC,FAHARalphG.Brindis,MD,MPH,MACCE.MagnusOhman,MD,FACCLesleyH.Curtis,PhD,FAHASusanJ.Pressler,PhD,RN,FAAN,FAHADavidDeMets,PhDFrankW.Sellke,MD,FACC,FAHARobertA.Guyton,MD,FACCWin-KuangShen,MD,FACC,FAHA预防指南分会SidneyC.Smith,Jr,MD,FACC,FAHA,ChairGordonF.Tomaselli,MD,FACC,FAHA,Co-Chair*当然委员。目录ACC/AHA降低心血管病风险指南序言和过渡1.引言...................................................................................91.1.工作组的组织.......................................................................91.2.文件审核和批准.....................................................................91.3.工作组的费用.........................................................................9PDF文件使用pdfFactoryPro试用版本创建风险评估:建议.........................................................................103.风险评估的方法.......................................................................114.新的汇集群组ASCVD风险公式的开发............................................................134.1.对评估首次严重ASCVD事件10年风险的建议................................................145.风险评估的含义..........................................................................156.关键问题(CQ)与系统化证据审查.......................................................186.1.关键问题1.........................................................................186.1.1.有关CQ1的系统审查和荟萃分析总结..............................................196.1.2.对CQ1的建议:定量风险评估后使用较新的风险指标....................................206.2.关键问题2............................................................................216.2.1.有关CQ2的证据总结................................................................216.2.2.对CQ2的建议:长期风险评估.......................................................227.对风险评估的实施注意事项.....................................................................238.证据缺陷与未来的研究需要.....................................................................249.结论.......................................................................................24附录1.有关CQ1的证据陈述....................................................................26附录2.有关CQ2的证据陈述...................................................................32附录3.原发表风险评分和现汇集群组公式的特点............................................34附录4.实施ASCVD汇集群组风险公式的开发和步骤...............................................36附录5.作者与企业和其它实体的关系(相关)....................................................41附录6ACC/AHA专家审核者与企业和其它实体的关系45附录7.略缩语.................................................................................46参考文献.......................................................................................47(译者注:页号为原文页号)ACC/AHA降低心血管病风险指南序言和过渡美国心脏病学会(ACC)和美国心脏协会(AHA)的目标是预防心血管(CV)疾病,通过专业化教育和研究改善对这些疾病的管理,制定指南、标准和政策,促进最佳病人护理和心血管健康。为了实现这些目标,ACC和AHA与国家心脏、肺和血液研究所(NHLBI)和利益相关者及专业组织合作,为评估CV风险的、改变生活方式减少心血管风险、血胆固醇管理、成人超重和肥胖制定临床实践指南。PDF文件使用pdfFactoryPro试用版本创建年,NHLBI对每个题目召集专家组进行严谨的系统化证据审查,提出关键问题(CQ)、解释证据和起草建议,开始制订这些指南。为了响应医学研究院(InstituteofM