1. Guidelines for the Management of Blood Lipids in China (2023)
After careful discussion, the Expert Committee on the Revision of the Guidelines decided to revise the "Guidelines for the Prevention and Treatment of Dyslipidemia" to the "Guidelines for the Management of Blood Lipids" (hereinafter referred to as the new guidelines). A total of 15 core questions were identified in 6 aspects (the general principles of guideline revision, the main content of the update, the overall risk assessment of ASCVD, the goals of lipid-lowering therapy, the pharmacological and non-pharmacological measures of lipid-lowering therapy, and the management of blood lipids in children and special populations).
The new guidelines still recommend LDL-C as the primary target for lipid interventions, with a target value determined by risk stratification. A target strategy with moderate-intensity statins as the starting drug therapy in addition to lifestyle interventions, combined with cholesterol absorption inhibitors and/or proprotein convertase subtilisin 9 inhibitors if necessary, is recommended. The new guidelines cover the management of blood lipids throughout the life cycle, from childhood to old age.
2. Chinese Guidelines for the Diagnosis and Treatment of Atrial Fibrillation
This paper elaborates on all aspects of atrial fibrillation management, and proposes the CHA2DS2-VASc-60 stroke score according to the characteristics of Asian atrial fibrillation population, re-evaluates the clinical application of atrial fibrillation screening, and emphasizes the significance of early rhythm control and the core position of catheter ablation in rhythm control.
3. Guidelines for the Management of Hypertension in the Elderly in China (2023)
Compared with the 2019 version of the guidelines, this edition of the guidelines cites the newly published epidemiological and clinical research evidence based on the elderly population with hypertension in China, emphasizes the balance between safety and efficacy in the diagnosis and treatment of hypertension in the elderly, highlights the importance of out-of-office blood pressure measurement in the diagnosis and treatment of hypertension in the elderly, and enriches the experience of hypertension in the elderly. The related content of cognitive dysfunction and multi-organ dysfunction, the drug treatment recommendations for hypertension and its associated diseases in the elderly were updated, the scope of special populations of hypertension in the elderly was expanded, and the management strategies of hypertension in the elderly were further optimized.
4. Update—2021 ESC Guidelines: Diagnosis and Treatment of Acute and Chronic Heart Failure
The 2023 ESC Focused Update updates the recommendations of the following sections of the 2021 ESC HF guideline, based on more than a dozen major randomized controlled trials and meta-analyses recently published on the treatment of HFp2: (1) chronic heart failure, including those with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) ;(12) acute heart failure; and (3) heart failure comorbidities and prevention of heart failure.
5. Chinese Expert Consensus on the Clinical Application of Anti-Arrhythmic Drugs
Drug therapy is the basic means of arrhythmia treatment, and since 2018, a new consensus and new classification of anti-arrhythmic drugs have been published internationally. Correspondingly, the Cardiovascular Disease Branch of the Chinese Medical Association and the Heart Rhythm Branch of the Chinese Society of Biomedical Engineering organized an expert group to summarize and analyze the research, classification, application status and new evidence of antiarrhythmic drugs at home and abroad on the basis of China's 2001 "Recommendations on Anti-Arrhythmic Drug Treatment", systematically analyze and evaluate the new understanding and new indications of traditional drugs, the mechanism of action, clinical application and proarrhythmic effects of new drugs, and put forward recommendations for the drug treatment of various arrhythmias.
6. 2023 ESC Guidelines: Management of Acute Coronary Syndromes
The European Society of Cardiology (ESC) published updated guidelines for the management of acute coronary syndromes (ACS) in August 2023. For the first time in history, the new guidelines combine the non-ST-elevation ACS (NSTE-ACS) guidelines and the ST-elevation myocardial infarction (SSTEMI) guidelines into a single guideline. In addition to differences in ECG findings and troponin levels, NSTE‐ACS and STEMI share many similarities in diagnostic pathways, invasive strategies, in-hospital treatment, and long-term management, so the new guidelines manage them as a contiguous disease spectrum, which is one of the most important new concepts in the guidelines.
7. 2023 ESC Guidelines: Management of Cardiovascular Disease in Diabetic Patients
Compared with the previous version of the guidelines, the current guidelines focus only on cardiovascular disease and diabetes, but do not address prediabetes, because there is currently insufficient evidence-based medical evidence for the management of this population. The new guidelines provide recommendations and guidance on cardiovascular risk stratification and screening, diagnosis and treatment of cardiovascular disease in patients with diabetes, and refer to the recommendations of the Diabetes Association for other aspects of diabetes management.
8. 2023 ESH Guidelines: Management of Hypertension
The 2023 guidelines contain several new conceptual elements that stem from research that follows the 2018 guidelines, deal more deeply with topics that were previously considered simply, and expand to several conditions that were not previously covered by the guidelines, although often coexisting with hypertension and leading to specific demands for medical management. Although primarily referring to hypertension in adults, they include, for the first time, basic recommendations for hypertension in children, adolescents and individuals transitioning to young hypertension;
In addition, while the evidence provided by the research on a particular issue in the text is sometimes not clear, each section provides, as is now customary in many guides, a brief list of key statements and recommendations for translating research achievements into practical use. We hope that this structure will make the ESH guidelines useful not only for practicing physicians, but also for hypertension specialists and researchers.
9. Chinese Expert Consensus on the Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction (2023)
Based on the Graded Assessment, Development and Evaluation of Recommendations (GRADE) approach, this consensus presents scientific evidence and expert opinions by proposing and answering outstanding problems in the diagnosis and treatment of HFpEF, covering the classification, diagnosis and treatment process, etiology and comorbidity screening, rehabilitation management, etc., which can provide guidance for the early diagnosis and treatment and standardized management of HFpEF by clinicians in mainland China. This consensus applies to patients aged > 18 years with clinically suspected or confirmed HFpEF and does not apply to patients with other types of heart failure.
10. Guidelines for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy in Chinese Adults (2023)
Compared with the 2017 guidelines, the main points of this guideline are as follows: the definition of HCM has been updated, and "quasi-phenotype" diseases are no longer included in HCM, which reduces clinical confusion, the clinical classification of HCM has been improved, which is conducive to guiding the clinical cognition and diagnosis and treatment of HCM, and the discussion of the characteristics of the course of HCM has been added, which is conducive to the understanding of disease risk stratification and prognostic assessment;
In the part of diagnostic methods, combined with the progress in recent years, the methods of echocardiography, cardiac magnetic resonance imaging (CMR), radionuclide imaging, pathological examination and other methods are introduced in a more detailed, comprehensive and in-depth manner, which is helpful for the accurate diagnosis and precise intervention of HCM The definition has been updated to simplify the list of disease-causing genes for ease of grasping, to include new evidence-based evidence in the field and to give specific recommendations, to list the genetic diagnosis process for clinicians to perform, to add a general framework for the HCM diagnosis and treatment process to facilitate clinicians' implementation, and to separate the risk stratification and prevention of sudden cardiac death (SCD) into a separate section to facilitate clinical application and evaluation;
With the improvement of the level of understanding of the concept of HCM treatment and rehabilitation, a separate chapter on lifestyle management and follow-up is included to help clinicians and patients grasp it, and a new chapter on multidisciplinary cooperation is set up according to the requirements of individualized management of HCM patients, which is conducive to the implementation of more accurate hierarchical diagnosis and treatment and prevention and control strategies for HCM patients.