medicina54巻7号

2017年06月発行

特集 外来診療必読エビデンス—日米比較で考える内科Standards of Excellence 各論

米国編　循環器病（心血管疾患）の一次予防

著者： 青井俊輔¹

所属機関： ¹

ページ範囲：P.1004 - P.1006

Point
◎最も重要な一次予防は生活習慣の改善である．
◎心血管疾患の一次予防において，スタチンは最も豊富なエビデンスがある．
◎アスピリンによる一次予防は，出血とのリスク・ベネフィットを考慮する必要がある．

参考文献

1）Yusuf S, et al：Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries（the INTERHEART study）；Case-control study. Lancet 364：937-952, 2004

2）Shepherd J, et al：Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med 333：1301-1307, 1995

3）Ridker PM, et al：Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359：2195-2207, 2008

4）Stone NJ：2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults；A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63：2889-2934, 2014

5）Stone NJ：2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults；A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129（25 Suppl 2）：S1-S45, 2014

6）Yusuf S, et al：Cholesterol lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med 374：2021-2031, 2016

7）Robinson JG, et al：Safety of very low low-density lipoprotein cholesterol levels with alirocumab；Pooled data from randomized trials. J Am Coll Cardiol 69：471-482, 2017

8）Guirguis-Blake JM, et al：Aspirin for the primary prevention of cardiovascular events；A systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 164：804-813, 2016