Huo Yong: Strengthen the "three high co-management" to curb dyslipidemia and improve the accessibility of innovative drugs

Source: People's Daily News

Recently, as the main advocate of the "three highs condominium", Huo Yong, chairman of the World Chinese Cardiovascular Physicians Association, president of the Asian Society of Cardiology, and professor of peking university first hospital, said when visiting the people's good doctor client of the new media of people's daily that dyslipidemia, like hypertension and hyperglycemia, is recognized as an important risk factor for cardiovascular disease, and is also the main culprit of serious cardiovascular events such as myocardial infarction and stroke. Since the "Healthy China Action (2019-2030)" was first proposed from the national level, this idea is being implemented step by step through the promotion of the government, medical institutions, and then to the society and the public.

"Compared with hypertension and diabetes, which have relatively good control results, it is especially necessary to make up for the shortcomings in the 'three high co-management' of blood lipid management, improve the awareness rate, detection rate, and treatment compliance rate, promote the accessibility of innovative drugs, meet the drug needs of patients, and realize the collaborative management of the main risk factors of cardiovascular and cerebrovascular diseases." Huo Yong said.

According to the newly released "China Cardiovascular Health and Disease Report 2020", the prevalence of cardiovascular disease in China continues to rise, and the number of people currently affected is estimated to be as high as 330 million. Asked about the reasons behind it, Huo Yong said that with the significant improvement of the quality of life of Chinese residents, the impact of bad living habits such as excessive dietary intake, too little exercise, and staying up late has gradually emerged, while the average life expectancy has been extended, the degree of population aging has intensified, and the "three highs" have occurred frequently.

"Hypertension, hyperglycemia, high blood lipids, each of these factors can independently trigger cardiovascular disease, and if it occurs simultaneously, it may multiply the risk of disease." Therefore, to do a good job in the comprehensive prevention and treatment of 'three high condominiums', it can play 1 1gt; The prevention and treatment effect of 2 greatly improves the overall prevention and control efficiency of cardiovascular disease. He said.

Talking about the focus of lipid management, Huo Yong said that the first goal of lipid-lowering therapy is to reduce the level of low-density lipoprotein cholesterol (LDL-C) in the blood. LDL-C, also known as "bad cholesterol", is an independent cause of myocardial infarction, and data show that every 1 mmol/L L LDL-C is effective in reducing the incidence of cardiovascular death events.

At the same time, Huo Yong also introduced that the existing lipid-lowering drugs are roughly divided into three categories: first, statin drugs, which are also the most abundant and most common cornerstone drugs with the most evidence-based medical evidence; then there is a category of intestinal cholesterol absorption inhibitors, which have a good synergistic effect with statins; and the last class is PCSK9 inhibitors that promote liver cholesterol metabolism.

"Clinically, the more high-risk the patient, the more we recommend starting intensive treatment as soon as possible, and the LDL-C level should not only be up to standard, but also lower and better." But in fact, many patients have suffered a myocardial infarction and stroke, even after receiving the largest tolerated dose of statin therapy, blood lipids are still not up to standard. Huo Yong said frankly.

"In the process of promoting the 'three high co-management', a particularly important goal is to let more high-risk and ultra-high-risk patients with dyslipidemia achieve lipid adjustment treatment standards." To achieve this goal, we need to meet the needs of patients as much as possible, so that patients can afford and use these good drugs and innovative drugs. Huo Yong said that this is inseparable from the efforts of all aspects: from the overall national policy, to promote the development of domestic new drugs and the introduction of foreign new drugs, to promote the improvement of the accessibility of innovative lipid-lowering drugs, he called for innovative drugs to be included in the medical insurance catalog, improve affordability, and more popular application at the grass-roots level; to continue to publicize and educate medical institutions and medical personnel, the proportion of abnormal blood lipid standards into the important link of assessing medical quality; in addition, blood lipid testing and patient education should also be strengthened to reduce drug anxiety for patients. Improve medication adherence and reduce the occurrence of cardiovascular events.

Finally, Huo Yong said that in order to promote the early arrival of the "inflection point" of the decline in the incidence of cardiovascular and cerebrovascular diseases, it is necessary to enhance the awareness of China's public health in China and healthy people, and the government should promote the implementation of policies and capital investment to establish a major disease prevention and control system, including cardiovascular and cerebrovascular diseases; it is necessary to establish a cooperation system with clear rights and responsibilities and roles for hospitals, medical institutions, academic associations and other organizations, from treatment to long-term management and disease prevention; in addition, it is necessary to form a good interaction with the public. Transform health awareness into a healthy culture, and promote a healthy lifestyle such as reasonable diet and exercise.