回答有关新指南的问题

The 美国心脏协会 and the American College of Cardiology released four cardiovascular prevention guidelines Tuesday, providing evidence-based guidance to help healthcare providers provide the best care to their patients in the areas of cholesterol, 肥胖, 生活方式和风险评估.

在接下来的几个月里，心.org will offer several new tools to help healthcare providers and patients alike better understand how to incorporate these recommendations to help prevent heart disease, 中风和其他心血管疾病.

In the meantime, here are answers to some of the basic questions you may be wondering about:

我知道我的整体健康状况不是很好.  新指南说我应该马上开始服用他汀类药物吗? 我还能怎么办呢?

你应该做两件事:首先，和你的医生谈谈. 其次，评估一下你应该尝试改变什么样的生活方式. 停止吸烟, eating healthier foods and getting enough exercise are things you always can and should be doing to improve your health. 美国心脏协会的“我的生活检查”工具可以提供帮助.

The new cholesterol guidelines say more people should be taking drugs called statins to avoid heart disease and stroke. 我怎么知道我是否需要开始服用这些药物?

请咨询您的医疗保健专业人员. They’ll do an overall evaluation of all factors that might put you at risk: whether you smoke, 你的体重, 你的血压, 身体活动水平, 饮食, blood sugar and cholesterol will all be considered to decide whether you need to add statins to the healthy lifestyle we should all be following.  如果风险评估表明他汀类药物对你有益, 您的医生将与您讨论潜在的利益和风险.  评估可能会建议你现在不需要药物治疗, 但是健康的生活方式仍然很重要. 

我已经在吃他汀类药物了. 新指南会改变我的剂量吗?

这对你的医疗保健提供者来说是一个很好的问题. The answer more than likely depends on the many factors relating to your overall cardiovascular health. One of the themes of these guidelines is that your doctor will now be looking at the big picture.  一般来说, 他汀类药物对已经患有心脏病的人最有帮助, 低密度脂蛋白胆固醇水平为190或更高的人, 年龄在40到75岁之间，患有2型糖尿病或其他风险的人.  The new guidelines will help determine the dose of statin that would be most appropriate for your level of risk, but your healthcare provider will use their overall knowledge of you to decide that.  There will be less focus on the exact level of LDL you achieve with your lifestyle and medication, 但仍会进行一些监测，以确保你的药物起作用. 

新的肥胖指南将肥胖视为一种疾病. 我如何知道自己是否肥胖，是否需要医生的帮助?

The simplest way to check right away is to use the 美国心脏协会’s online calculator to check your body mass index, 或身体质量指数. 当你看到你的医疗保健提供者, 他或她将开始根据你的BMI评估你是否需要治疗. 如果你的身体质量指数超过30，你就被认为是肥胖，需要治疗. 

我的医生会如何治疗我的肥胖?

The new guidelines encourage doctors to counsel you and to get really involved in your care. The guidelines also provide tools your doctor needs to become very involved in your case and work in close partnership with you. The guidelines recognize that there is no set weight-loss program that works for everyone, 每个人都需要自己的计划. Your doctor may put you on a medically supervised weight-loss plan or advise bariatric surgery.

保险呢?? 将涵盖哪些方面的肥胖治疗?

Private plans vary widely on what they cover, so it’s best to check with your insurance provider. 然而, 根据《平价医疗法案, Medicare and most private insurance plans already cover 肥胖 screening and counseling for adults with a BMI of 30 or higher, and 饮食 counseling for any adult with high cholesterol or other risk factor for cardiovascular disease. 从2014年开始, all new plans sold through the health insurance marketplace must also provide free coverage for these and other preventive services.

生活方式指南是否建议做出重大改变?

There are no major changes to the advice the 美国心脏协会 has always given. 本质上, 我们继续敦促人们遵循我们所说的“生活的简单7”,这些都是可以降低患病风险的因素和行为:不要吸烟, 多做运动, 健康饮食, 保持健康的体重, 控制你的血压, 胆固醇和血糖.

新指南有没有建议我应该考虑的重大饮食改变?

No. 你应该坚持我们一直推荐的饮食模式, 一种包括大量水果的食物, 蔬菜, 全谷物,  鱼和其他瘦肉蛋白, 但不是过量的钠, 脂肪或添加糖. 美国心脏协会营养中心提供了更多的指导. 

钠呢?? 我应该不吃盐吗?

你的身体和饮食中都需要钠, 但美国人的平均摄入量超过3倍,400 milligrams each day – an amount that is far too high and can increase your risk of high blood pressure, 中风和其他重大问题. 除非你的医生告诉你你需要更多的盐, 指南继续敦促你减少饮酒量. 新的指导方针仍然建议1,每天500毫克对血压影响最大. But it also says people with high blood pressure can target a “step-down” amount of 2,400毫克，快到1了,500. 

风险评估指引对我来说意味着什么?

This is a guideline that’s really intended as a guide for your healthcare providers. The upshot is, your healthcare provider now has new tools to better evaluate your overall risk. 真正的进步是有更好的非裔美国人数据.  再一次。, a primary theme of these guidelines is looking at the big picture of your cardiovascular health. 你的医生会帮你的.