心血管健康和疾病监测的经验与启示

心血管健康与疾病监测是掌握人群心血管疾病及其影响因素的流行特征和规律的重要措施,有利于促进居民心血管健康、降低疾病负担.本文对国际组织及美国、芬兰和印度等国家开展的心血管健康与疾病监测工作进行综述,总结其在监测体系构建、监测指标与内容设置、监测新技术应用等方面的实践经验.为我国开展持续、稳定的心血管健康与疾病监测工作提...     

心血管代谢疾病诊断、治疗、防控一体化的必要性

心血管代谢疾病是人类健康的第一杀手,是中国人群的主要死亡原因之一。它给我国的国民健康和家庭生活造成巨大威胁。当前,心血管代谢疾病的危险因素并未得到有效控制,对其的防控和基础研究都有很大的改进空间。为了更好地控制心血管代谢疾病的流行,我们亟需对疾病的诊断、治疗和防控进行改革,建立预防、诊断、治疗一体化的立体综合防控体系。     

“一带一路心脏介入培训项目”在上海市胸科医院正式启动

正2016年9月,经国家卫计委国际合作司批准立项,在中国医师协会领导下,由中国医师协会,中国心血管健康联盟共同发起了"一带一路心脏介入培训项目",该项目积极响应国家"一带一路"倡议,鼓励在心血管发展领域不断推进创新合作模式,促进沿线国家心血管医师培训和技能提高,帮扶沿线国家进行卫生领域能力建设和医疗体系完善,以点带面,从线到片,扩大合作格局。上海市胸科医院作为中国首批"一带一路"心脏介入培训基地     

铭记服务使命,践行社会责任——中国心血管健康志愿者招募启动仪式圆满举行

正中国心血管健康志愿者招募启动仪式在烟台举行,中国心血管健康联盟主席葛均波院士,中国心血管健康联盟副主席霍勇教授,中国心血管健康联盟理事陈纪言教授、张大东教授、刘峰教授出席了本次启动仪式。同时有《医师报》《医学论坛报》《医学界》《门诊杂志》《365医学网》等多家专业媒体见证这一具有重大意义的时刻。葛均波院士指出发展一流志愿者服务体系,为中国心血     

心脏检查，夏季护心第一步

心血管健康对于糖尿病患者来说意义十分重大，因为糖尿病人群是心血管疾病高危人群这一事实是确定无疑的。进一步重视糖尿病的防治，就是要尽量做到多因素综合干预，而首要的一步就是定期给心脏做检查。     

第二十一届全国介入心脏病学论坛会议通知

正为促进我国心脏病学领域最新研究成果的推广与交流,了解国内外心脏病学的新技术、新方法、新趋势,发展和提高我国介入心脏病学的诊疗技术,由中国医师协会、中国心血管健康联盟、心血管健康(苏州工业园区)研究院、中国介入心脏病学杂志主办,宁夏医科大学总医院、宁夏医师协会、宁夏心血管内科医师分会、宁夏医学会、宁夏心血管     

关于联合开展“中国心血管疾病规范化诊疗管理暨县级医疗机构介入诊疗能力提升项目”战略合作框架协议在沪签署

<正>2016年5月28日心血管健康(苏州工业园区)研究院与赛诺菲中国在上海共同签署"中国心血管疾病规范化诊疗管理暨县级医疗机构介入诊疗能力提升项目"战略合作框架协议。旨在共同促进中国心血管健康事业发展,提高中国心血管疾病防治水平,加强县级医院心血管疾病防治及介入诊疗能力建设。北京大学第一医院心内科及心脏中心主任、心血管健康研究院院长霍勇教授,复旦大学附属中山医     

心血管代谢疾病诊断、治疗、防控一体化:实施框架

心血管代谢疾病是健康的头号杀手。为了遏制心血管代谢疾病的流行,我们亟需建立心血管代谢疾病诊断、预防、治疗一体化体系。具体而言,各级政府在制定政策时应充分考虑心血管代谢疾病的防治。加强心血管代谢疾病防治知识在国民,特别是青少年中的教育科普。利益相关者,即医疗保健部门,研究机构及疾病预防控制中心应保持合作;构建信息共享平台,改善现有医疗记录以更好地预测、防控疾病。运用大数据分析评估潜在的治疗及干预靶点,加快药物研发进程。以"一带一路"为契机,中国需要在遏制心血管代谢疾病方面起到领导性的作用。     

中国胸痛联盟吹响集结号，为中国胸痛中心纵深化发展创造新机遇

<正>2019年10月22日,中国胸痛中心联盟成立大会暨胸痛中心质控会议在北京成功召开。国家卫生健康委员会医政医管局焦雅辉副局长、国家卫生健康委员会医政医管局医疗资源处王毅处长,以及中国心血管健康联盟主席、复旦大学附属中山医院葛均波院士,中国心血管健康联盟副主席、北京大学第一医院霍勇教授,中国心血管健康联盟秘书长方唯一教授,中国人民解放军南部战区总医院向定成教授等众多心血管领域专家出席会议。在他们的见证下,中国胸痛中心联盟正式成立。中国胸痛中心联盟的成立标志着中国胸痛中心建设发展即将进入新纪元、迎来新机遇。"三年1000家"胸痛中心阶段性目标的达成,意     

中国心血管健康与疾病报告2019概要

正2020年9月,自2005年以来每年组织专家编撰的《中国心血管病报告》改版为《中国心血管健康与疾病报告》并正式发布~([1])。此次改版后的《中国心血管健康与疾病报告》,增加了心血管健康行为、康复、技术创新与转化等内容,力求倡导心血管全生命周期的健康管理。     

Pan-canadian cardiovascular data definitions and quality indicators: a status update

After the 2009 publication of Building a Heart Healthy Canada, the Canadian Cardiovascular Society was commissioned to address a long-standing information gap related to the compatibility and comparability of data on the quality of cardiovascular care in Canada. Through collaboration between the Canadian Institute for Health Information, the Institute for Clinical Evaluative Sciences, the Public Health Agency of Canada, and 5 regional cardiovascular registries, 2 committees were tasked with developing standardized cardiovascular data definitions and quality indicators. The work culminated in national consensus on the definitions of 55 patient, disease, and therapeutic variables (core and optional) to facilitate cardiovascular care comparisons within and across Canada. Supplemental data definition chapters were then developed on acute coronary syndrome and coronary angiography/revascularization, with chapters on heart failure and atrial fibrillation electrophysiology to follow. This foundational work led to a critical appraisal of cardiac quality indicator development initiatives via the Appraisal of Guidelines for Research and Evaluation II (AGREE II) Quality Indicator tool, followed by the development of quality indicator catalogues on heart failure and atrial fibrillation. These indicators will be embedded within the clinical practice guidelines of the Canadian Cardiovascular Society, facilitating national comparisons across Canada on cardiovascular disease incidence, prevalence, patterns and quality of care, and clinical outcomes. This methodology-achieving national stakeholder consensus on a standardized process for the development and selection of cardiovascular quality indicators-illustrates the capacity to reach agreement by drawing on expertise and research across diverse organizational mandates and agendas, potentially contributing to improved cardiovascular care and outcomes for patients.     

The role of lipid metabolism in the prevention of coronary heart disease

Prevention of cardiovascular disease should be considered as a continuum from low to high risk: those at the highest risk are patients with clinically manifest cardiovascular disease, followed by subjects without known cardiovascular disease at different levels of risk from high to low. Today there is clear evidence that an independent relationship exists between plasma LDL cholesterol levels and the risk for coronary heart disease. The relationship between other plasma lipoproteins and atherosclerosis is more complex. The threshold for individuals requiring LDL cholesterol reduction is determined by epidemiological data, randomized controlled trials, and economic considerations. Patients with familial dyslipidemia suffer early coronary morbidity and mortality. For these patients, consequent lowering of LDL cholesterol should be the primary objective. For patients with established coronary heart disease or other atherosclerotic disease and for those with diabetes, there is significant evidence that reducing LDL cholesterol, irrespective of the initial values, reduces the risk of further coronary events, stroke, and total mortality. For asymptomatic individuals, the treatment of plasma lipids should be based on their absolute coronary risk, including other cardiovascular risk factors. The goals for plasma LDL cholesterol have been set in national and international recommendations. The goals for LDL cholesterol in patients with low, moderate and high coronary risk are <160, <130 and 100 mg/dl, respectively. In some very high risk patients LDL level markedly below 100 mg/dl should be aimed at. HDL cholesterol and triglyceride measurements should be used to identify individuals at high multifactorial risk of cardiovascular disease and used as additional considerations in the selection of lifestyle and drug interventions.     

Socioeconomic inequalities in cardiovascular disease mortality; an international study.

BACKGROUND: Differences between socioeconomic groups in mortality from and risk factors for cardiovascular diseases have been reported in many countries. We have made a comparative analysis of these inequalities in the United States and 11 western European countries. The aims of the analysis were (1) to compare the size of inequalities in cardiovascular disease mortality between countries, and (2) to explore the possible contribution of cardiovascular risk factors to the explanation of between-country differences in inequalities in cardiovascular disease mortality. DATA AND METHODS: Data on ischaemic heart disease, cerebrovascular disease and total cardiovascular disease mortality by occupational class and/or educational level were obtained from national longitudinal or unlinked cross-sectional studies. Data on smoking, alcohol consumption, overweight and infrequent consumption of fresh vegetables by occupational class and/or educational level were obtained from national health interview or multipurpose surveys and from the European Union's Eurobarometer survey. Age-adjusted rate ratios for mortality were correlated with age-adjusted odds ratios for the behavioural risk factors. RESULTS: In all countries mortality from cardiovascular diseases is higher among persons with lower occupational class or lower educational level. Within western Europe, a north-south gradient is apparent, with relative and absolute inequalities being larger in the north than in the south. For ischaemic heart disease, but not for cerebrovascular disease, an even more striking north-south gradient is seen, with some 'reverse' inequalities in southern Europe. The United States occupy intermediate positions on most indicators. Inequalities in cardiovascular disease mortality are associated with inequalities in some risk factors, especially cigarette smoking and excessive alcohol consumption. CONCLUSIONS: Socioeconomic inequalities in cardiovascular disease mortality are a major public health problem in most industrialized countries. Closing the gap between low and high socioeconomic groups offers great potential for reducing cardiovascular disease mortality. Developing effective methods of behavioural risk factor reduction in the lower socioeconomic groups should be a top priority in cardiovascular disease prevention.     

Outdoor air pollution: counseling and exposure risk reduction

Air pollution is monitored on a daily basis in large population centers in the United States and reported to the general public through a variety of media outlets as the Air Quality Index. This index is based on current national air quality standards for criteria air pollutants established by the US Environmental Protection Agency. Patients at increased risk for adverse effects of inhaled air pollutants include those who have been diagnosed with chronic lung disease and cardiovascular disease, including asthma, chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, and peripheral vascular disease, although others may also be at risk during periods of unusually high pollutant levels. These patients should be educated regarding what symptoms may be related to poor air quality and how they can monitor the Air Quality Index to modify their activity to prevent symptoms and other adverse events. Heavy outdoor exertion should be avoided on days expected to have poor air quality, or performed earlier in the day on days when outdoor activity cannot be avoided. We recommend advising patients in clear, strong, personalized language that air pollution is harmful and that persons with cardiopulmonary disease are at elevated risk of experiencing a serious adverse health effect from exposure.     

Links between adipose tissue and thrombosis in the mouse

Obesity has become a global epidemic and carries a considerable negative impact in regard to quality of life and life expectancy. A primary problem is that obese individuals are at increased risk of suffering from cardiovascular disease complications such as myocardial infarction and stroke. Because fat accumulation is a consistent aspect of obesity, mechanisms that may link adipose tissue to cardiovascular disease complications should be considered. Proteins expressed from adipose tissue, known as adipokines, are hypothesized to have important effects on the progression and incidence of cardiovascular disease complications. This review examines the evidence that adipokines play a direct role in vascular thrombosis, an important event in cardiovascular disease complications.     

Efficacy and safety in clinical trials in cardiovascular disease

Mortality and morbid events are insensitive guides to the efficacy and safety of interventions in chronic cardiovascular disease (CVD). To enhance the ability to find new and effective long-term treatments, especially for the early stages of CVD, a revised strategy for clinical trials should emphasize efficacy on disease progression while monitoring symptoms and quality of life as guides to clinical benefit. Mortality, which is uncommon except in acute or advanced disease, provides at best a crude guide to net efficacy and safety. It must be monitored to support demonstrated efficacy on disease progression without adverse safety effects. This revised approach, made possible by our enhanced ability to monitor the progression of disease, should make it possible to study earlier disease and to improve cardiovascular health while reducing health care costs.     

Efficacy and safety in clinical trials in cardiovascular disease.

Mortality and morbid events are insensitive guides to the efficacy and safety of interventions in chronic cardiovascular disease (CVD). To enhance the ability to find new and effective long-term treatments, especially for the early stages of CVD, a revised strategy for clinical trials should emphasize efficacy on disease progression while monitoring symptoms and quality of life as guides to clinical benefit. Mortality, which is uncommon except in acute or advanced disease, provides at best a crude guide to net efficacy and safety. It must be monitored to support demonstrated efficacy on disease progression without adverse safety effects. This revised approach, made possible by our enhanced ability to monitor the progression of disease, should make it possible to study earlier disease and to improve cardiovascular health while reducing health care costs.     

The burden of blood pressure: where are we and where should we go?

Hypertension and related diseases are a global burden of cardiovascular disorders. Ischemic heart disease and cardiovascular disease rank fourth and fifth among the 10 leading causes of mortality worldwide. A generation from now, these diseases will be an epidemic for which we should be ready and against which we should attempt to find the best preventive measures. In Canada, the percentage of cardiovascular deaths increases with age. After the age of 50 years, these deaths actually exceed 50% of total mortality. Cardiovascular diseases also have the highest financial health care costs. The newest guidelines from national and international societies have a unifying goal of controlling cardiovascular burden. Guidelines of the international societies are written for a worldwide audience, including countries with very variable health care systems. However, the supreme goal is universal - to lower blood pressure and other risk factors to reduce the risk of cardiovascular disease with its fatal consequences.     

Current strategies to diminish the impact of cardiovascular diseases in women

The European Society of Cardiology (ESC) has recently promoted the "Women at Heart" program in order to organize initiatives targeted at promoting research and education in the field of cardiovascular diseases in women. Comparisons of the gender differences in specific disease and treatment trends across Europe are provided by analyzing data from the Euro Heart Surveys. A Policy Conference has been organized with the objective to summarize the state of the art from an European perspective, to identify the scientific gaps and to delineate the strategies for changing the misperception of cardiovascular diseases in women, improving risk stratification, diagnosis, and therapy from a gender perspective and increasing women representation in clinical trials. A Statement from the Policy Conference has been provided and published in the European Heart Journal. Synergic activities should be undertaken at European level with the support of national scientific societies, European institutions, national health care authorities, patients' associations, and foundations. The commitment of the Board of the ESC is that these initiatives contribute to increase the awareness across Europe that cardiovascular disease is the primary cause of death in women and to improve the knowledge of risk factors, presentation and treatment of cardiovascular diseases in women.     

心律失常介入治疗数据库平台建设：基本原理和设计方案

背景 临床注册研究是近期国内外学术界兴起的一种新的临床研究形式.美国国家心血管病数据注册系统于2005年开展了针对植入型心律转复除颤器（ICD）的注册.心律失常介入治疗的数据库目的是在依托国家心血管病中心筹建的统一数据库平台基础上,开展植入型器械治疗注册系统和导管消融治疗注册系统.基本原理 根据研究要求,建设我国心律失常介入治疗信息与研究平台的专用网页.建立符合国际标准的电子化、信息化临床研究数据管理和统计分析平台,对研究中各个子项目的数据进行数据监查、数据管理、质量控制及统计分析.设计方案 为前瞻性的、多中心的、开放性注册研究,共有24家医院参加研究.依托国家心血管病中心筹建的统一数据库平台,设计心律失常介入治疗的数据注册系统,包括植入型器械治疗注册系统以及导管消融治疗注册系统.前者包括心脏起搏器、ICD和心脏再同步治疗（CRT）的植入登记数据库和随访数据库.后者包括阵发性室上性心动过速、室性快速心律失常和房性快速心律失常的手术登记数据库和随访数据库.结论 心律失常介入治疗的数据库平台建设将有助于规范心律失常介入治疗的临床行为,实现网络数据库与临床工作平台的合理对接,提高医疗质量和医疗安全.