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Abstract：
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of death around the world. Most CVDs-related death can be prevented by the optimal management of risk factors such as unhealthy diet and physical inactivity. Clinical practice guidelines (CPGs) for CVDs, provide some evidence-based recommendations which help healthcare professionals to achieve the best care for patients with CVDs. This systematic review aims to appraise the methodological quality of CPGs systematically and summarize the recommendations of self-managed non-pharmacological interventions for the prevention and management of CVDs provided by the selected guidelines.
METHODS: A comprehensive electronic literature search was conducted via six databases (PubMed, Medline, The Cochrane Library, Embase, CINAHL, and Web of Science), seven professional heart association websites, and nine guideline repositories. The Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument was adopted to critically appraise the methodological quality of the selected guidelines. Content analysis was used to summarise recommended self-managed non-pharmacological interventions for CVDs.
RESULTS: Twenty-three CPGs regarding different CVDs were included, in which four guidelines of CVDs, three for coronary heart diseases, seven for heart failure, two for atrial fibrillation, three for stroke, three for peripheral arterial disease, and one for hypertrophic cardiomyopathy. Twenty CPGs were appraised as high quality, and three CPGs as moderate quality. All twenty-three CPGs were recommended for use with or without modification. The domain of \"Editorial Independence\" had the highest standardized percentage (93.47%), whereas the domain of \"Applicability\" had the lowest mean domain score of 75.41%. The content analysis findings summarised some common self-managed non-pharmacological interventions, which include healthy diet, physical activity, smoking cessation, alcohol control, and weight management. Healthy diet and physical acidity are the most common and agreed on self-managed interventions for patients with CVDs. There are some inconsistencies identified in the details of recommended interventions, the intervention itself, the grade of recommendation, and the supported level of evidence.
CONCLUSIONS: The majority of the summarized non-pharmacological interventions were strongly recommended with moderate to high-quality levels of evidence. Healthcare professionals and researchers can adopt the results of this review to design self-managed non-pharmacological interventions for patients with CVDs.
METHODS: A comprehensive electronic literature search was conducted via six databases (PubMed, Medline, The Cochrane Library, Embase, CINAHL, and Web of Science), seven professional heart association websites, and nine guideline repositories. The Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument was adopted to critically appraise the methodological quality of the selected guidelines. Content analysis was used to summarise recommended self-managed non-pharmacological interventions for CVDs.
RESULTS: Twenty-three CPGs regarding different CVDs were included, in which four guidelines of CVDs, three for coronary heart diseases, seven for heart failure, two for atrial fibrillation, three for stroke, three for peripheral arterial disease, and one for hypertrophic cardiomyopathy. Twenty CPGs were appraised as high quality, and three CPGs as moderate quality. All twenty-three CPGs were recommended for use with or without modification. The domain of \"Editorial Independence\" had the highest standardized percentage (93.47%), whereas the domain of \"Applicability\" had the lowest mean domain score of 75.41%. The content analysis findings summarised some common self-managed non-pharmacological interventions, which include healthy diet, physical activity, smoking cessation, alcohol control, and weight management. Healthy diet and physical acidity are the most common and agreed on self-managed interventions for patients with CVDs. There are some inconsistencies identified in the details of recommended interventions, the intervention itself, the grade of recommendation, and the supported level of evidence.
CONCLUSIONS: The majority of the summarized non-pharmacological interventions were strongly recommended with moderate to high-quality levels of evidence. Healthcare professionals and researchers can adopt the results of this review to design self-managed non-pharmacological interventions for patients with CVDs.
摘要：
背景：心血管疾病（CVDs）是世界范围内的主要死亡原因。大多数与心血管疾病相关的死亡可以通过对不健康饮食和缺乏运动等风险因素的最佳管理来预防。CVDs的临床实践指南(CPGs),提供一些基于证据的建议，帮助医疗保健专业人员为心血管疾病患者实现最佳护理。本系统综述旨在系统地评估CPGs的方法学质量，并总结所选指南提供的自我管理的非药物干预措施预防和管理CVD的建议。
方法：通过六个数据库（PubMed，Medline,科克伦图书馆,Embase,CINAHL,和WebofScience)，七个专业心脏协会网站，和九个指南库。准则的评估，采用了研究与评估II（AGREEII）工具来严格评估所选指南的方法学质量。内容分析用于总结推荐的自我管理非药物干预措施。
结果：包括关于不同CVD的23个CPG，其中CVD的四个准则，三个用于冠心病，七例心力衰竭，两个用于心房颤动，三个中风，三个用于外周动脉疾病，一个是肥厚型心肌病.20个CPG被评估为高质量，和三个CPG作为中等质量。建议使用所有23个CPG，可进行或不进行修改。“编辑独立性”领域的标准化百分比最高（93.47％），而“适用性”领域的平均领域得分最低，为75.41%。内容分析结果总结了一些常见的自我管理的非药物干预措施，其中包括健康的饮食，身体活动,戒烟,酒精控制,和体重管理。健康饮食和身体酸度是最常见的，并且是对CVD患者进行自我管理干预的共识。在建议的干预措施的细节中发现了一些不一致之处，干预本身，推荐等级，和支持的证据水平。
结论：强烈建议大多数总结的非药物干预措施具有中等至高质量的证据水平。医疗保健专业人员和研究人员可以采用本综述的结果，为CVD患者设计自我管理的非药物干预措施。
方法：通过六个数据库（PubMed，Medline,科克伦图书馆,Embase,CINAHL,和WebofScience)，七个专业心脏协会网站，和九个指南库。准则的评估，采用了研究与评估II（AGREEII）工具来严格评估所选指南的方法学质量。内容分析用于总结推荐的自我管理非药物干预措施。
结果：包括关于不同CVD的23个CPG，其中CVD的四个准则，三个用于冠心病，七例心力衰竭，两个用于心房颤动，三个中风，三个用于外周动脉疾病，一个是肥厚型心肌病.20个CPG被评估为高质量，和三个CPG作为中等质量。建议使用所有23个CPG，可进行或不进行修改。“编辑独立性”领域的标准化百分比最高（93.47％），而“适用性”领域的平均领域得分最低，为75.41%。内容分析结果总结了一些常见的自我管理的非药物干预措施，其中包括健康的饮食，身体活动,戒烟,酒精控制,和体重管理。健康饮食和身体酸度是最常见的，并且是对CVD患者进行自我管理干预的共识。在建议的干预措施的细节中发现了一些不一致之处，干预本身，推荐等级，和支持的证据水平。
结论：强烈建议大多数总结的非药物干预措施具有中等至高质量的证据水平。医疗保健专业人员和研究人员可以采用本综述的结果，为CVD患者设计自我管理的非药物干预措施。
