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[GWICC2012]将非传染性疾病降低25%, 面临挑战——ACC主席William A. Zoghbi教授专访

作者:  W.A.Zoghbi   日期:2012/10/15 13:19:10

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要降低25%,这是针对心血管死亡、癌症死亡和糖尿病及肺部疾病的发病率,以及能够在一个相对短的时间内做到这一点,我们知道我们面临着一些挑战。这毫无疑问。在这些障碍中,不管你信或不信,第一位是吸烟。你如何能降低吸烟率?在一些国家吸烟涉及到高达50%的人口。


 International Circulation: What are some of the problems in the prevention and management of cardiovascular disease in the United States and what lessons can China learn from your experience of these problems?
Dr Zoghbi: Although we know so much about how to prevent cardiovascular disease and stroke, if you look underground at how effective we have been in delivering care and for individuals to uptake this care, we have not done well. There is what is called a Million Heart Initiative in the United States combining efforts from the government, the CDC, the Department of Health and Human Services, the professional organizations we have mentioned (ACC, AHA and so on), pharmacists and industry pulling together to try to educate as a priority. Blood pressure control is no more than 50% in the United States. Smoking 20%. Physical activity low. People who need to take aspirin is low, 40-50%. There are many challenges in educating individuals, engaging and motivating them and if they need medication, taking the medication and being compliant and hopefully affording it. I am sure that these challenges mirror image themselves in almost every country to a different magnitude. You may have more smoking in China than the United States and I know that Professor Hu Dayi and many others have been pushing to reduce smoking. But when you go into rural areas, the question is about knowledge of the disease process for them to detect first and then to manage it next. I think this is an issue in how we do this and we need the help of government, professional organizations and foundations getting into the community and spreading the word using media and whatever is available because each part of society will use different methods of accessing it from the very rudimentary to the most sophisticated.
《国际循环》:在美国心血管疾病预防和管理中有哪些问题,根据您的经验,中国从这些问题中可以吸取什么教训?
 Dr Zoghbi:关于如何预防心血管疾病和卒中,虽然我们知道很多,但如果你深入探查我们在提供医疗服务上以及对个体而言获取这种医疗服务的有效性如何,会发现我们还没有做得很好。有联合了来自政府、疾病预防控制中心(CDC)、卫生和人类服务部、我们所提到的专业组织(ACC,AHA等等)、药剂师和医药产业努力的美国所谓“百万心脏”倡议,齐心协力来尝试推进教育作为优先事项。美国的血压控制不超过50%。吸烟20%。体力活动量低下。需要服用阿司匹林者比例低,40%~50%。在教育个体、激励和诱导他们方面有很多的挑战,如果他们需要药物治疗,那么就服用药物并有依从性,且但愿负担得起。我相信,在几乎每一个国家,这些挑战都会以不同的程度出现。与美国相比,在中国可能有更多的吸烟,我了解到,胡大一教授和其他许多人一直在推动减少吸烟。但是,当你去到农村地区,问题是对他们而言首先是觉察到关于疾病过程的知识,然后才是管理它。我认为我们如何做到这一点是一个问题,我们需要政府、专业组织和基金会的帮助,以进入社区,利用媒体以及任何可用的途径来传播这些信息,因为社会的每个部分将使用不同的方法来获取这些信息,从非常简陋的到最先进的方法都会有。

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非传染性疾病吸烟运动预防W.A.Zoghbi

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