動脈硬化性心血管疾病初級預防指引之制訂

Developing Guidelines for Primary Prevention of ASCVD

動脈粥樣硬化性心血管疾病（atherosclerotic cardiovascular disease，ASCVD）是全球及台灣主要死因之一，盛行率極高，對全球健康造成重大衝擊。因此，中華民國心臟學會（Taiwan Society of Cardiology，TSOC）制定基於最佳實證之預防指引，協助臨床決策，涵蓋初始預防（包括國家政策、健康教育推廣、臨床危險因子的初級預防及其管理與控制）。本指引涵蓋ASCVD全範疇，包括慢性冠心症、急性冠心症、腦血管疾病、周邊動脈疾病及主動脈瘤。為提升醫師及大眾的醫學教育與健康促進，我們提出初級預防口號（2H2L）：「健康飲食與健康生活型態，幫助你的人生，也拯救你的生命」。同時提出可調整危險因子／增強因子及相關策略縮寫「ABC2D2EFG-I’M2 ACE」：adiposity（肥胖）、blood pressure（血壓）、cholesterol and cigarette smoking（膽固醇與吸菸）、diabetes mellitus and dietary pattern（糖尿病與飲食型態）、exercise（運動）、frailty（衰弱）、gout／hyperuricemia（痛風／高尿酸血症）、inflammation／infection（發炎／感染）、metabolic syndrome and metabolic dysfunction-associated fatty liver disease（代謝症候群與代謝功能異常脂肪肝）、atmosphere（environment）（環境）、chronic kidney disease（慢性腎臟病）、easy life（sleep well and no stress）（好好生活：睡眠充足、無壓力）。健康飲食、規律運動及體重控制仍是預防策略的核心。為了預防ASCVD，我們根據台灣食品指南，建議攝取6大類食物的適量，並進行每週150分鐘的中等強度身體活動，或每週75分鐘的高強度身體活動。

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide and in Taiwan, with a high prevalence and significant impact on global health. Therefore, the Taiwan Society of Cardiology (TSOC) has developed evidence-based prevention guidelines to assist clinical decision-making, covering primordial prevention (including national policy, health education promotion, primary prevention and management/control of clinical risk factors). These guidelines encompass the full spectrum of ASCVD, including chronic coronary syndrome, acute coronary syndrome, cerebrovascular disease, peripheral arterial disease, and aortic aneurysm. To enhance medical education and health promotion for physicians and the public, we propose the primary prevention slogan (2H2L):“Healthy Diet and Healthy Lifestyles to Help Your Life and Save Your Lives”. We also introduce the abbreviation for modifiable risk/enhancing factors and related strategies“ABC2D2EFG-I’M2 ACE”: Adiposity, Blood pressure, Cholesterol and Cigarette smoking, Diabetes mellitus and Dietary pattern, Exercise, Frailty, Gout/hyperuricemia, Inflammation/infection, Metabolic syndrome and Metabolic dysfunction-associated fatty liver disease, Atmosphere (environment), Chronic kidney disease, Easy life (sleep well and no stress). Healthy diet, regular exercise, and weight control remain the core of prevention strategies. To prevent ASCVD, we recommend following the Taiwan Food Guide for appropriate intake from six food groups and engaging in 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week.