Abstract：
UNASSIGNED: Cardiovascular diseases are the leading cause of death globally. The aim of this overview of systematic reviews was to compare the effectiveness of different pharmacological and non-pharmacological interventions for the primary prevention of cardiovascular disease.
UNASSIGNED: A structured search of the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE and the Database of Abstracts of Reviews of Effects archive was conducted to find systematic reviews that reported the effect of various pharmacological and non-pharmacological interventions for the primary prevention of cardiovascular disease from inception to March 2021. References of included studies were also checked. The included systematic reviews\' methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 instrument (range, 0-16). The outcomes of each included review\'s meta-analysis were extracted and described narratively.
UNASSIGNED: This study analysed 95 systematic reviews, including 41 on non-pharmacological interventions and 54 on pharmacological interventions for cardiovascular health. The majority of the reviews focused on lipid-lowering interventions (n = 25) and antiplatelet medications (n = 21), followed by nutritional supplements, dietary interventions, physical activity, health promotion and other interventions. Only 1 of the 10 reviews addressing cardiovascular mortality showed a potential benefit, while the others found no effect. Antiplatelets were found to have a beneficial effect on all-cause mortality in 2 out of 12 meta-analyses and on major cardiovascular disease events in 8 out of 17 reviews. Lipid-lowering interventions showed beneficial effects on cardiovascular disease mortality, all-cause mortality and major cardiovascular disease events in varying numbers of the reviews. Glucose-lowering medications demonstrated significant benefits for major cardiovascular events, coronary heart disease events and mortality. However, the combination of dietary interventions, physical activities, nutritional supplements and polypills showed little or no significant benefit for major cardiovascular outcomes or mortality.
UNASSIGNED: More research is needed to determine whether the effect of treatment varies depending on population characteristics. The findings of this review should be interpreted with caution because the majority of studies of non-pharmacological interventions compare primary prevention with usual care, which may include recommended pharmacological treatment in higher-risk patients (e.g. statins and/or antihypertensive medications, etc.). In addition, randomised controlled trial evidence may be better suited to the study of pharmacological interventions than dietary and lifestyle interventions.
UNASSIGNED: This umbrella review captured the variability in different interventions on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease and identified areas that may benefit from further research. Specifically, this review focused on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease. Researchers may use these findings as a resource to direct new intervention studies and network meta-analyses to compare the efficacy of various interventions based on these findings.
UNASSIGNED: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme as award number 17/148/05.
Heart and blood vessel diseases are the top cause of death worldwide. This study aimed to compare the effectiveness of various drug-based and non-drug-based methods in preventing these diseases. We searched databases like Cochrane, MEDLINE, EMBASE and the Database of Abstracts of Reviews of Effects archive to find reviews about different ways to prevent heart and blood vessel diseases up until March 2021. The results showed that only 1 out of 10 reviews found a possible benefit in reducing heart-related deaths, while the other 9 found no effect. Medicines that lower blood sugar levels had a positive impact on reducing major heart events, heart disease and death. However, combining dietary changes, exercise, nutritional supplements and polypills had little or no effect on reducing heart-related events, deaths due to heart disease or deaths from all causes. This review examined the available evidence on ways to prevent heart and blood vessel diseases and identified areas where more research could be beneficial. Future studies could compare the effectiveness of different interventions using new methods and analyses.
UNASSIGNED: A structured search of the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE and the Database of Abstracts of Reviews of Effects archive was conducted to find systematic reviews that reported the effect of various pharmacological and non-pharmacological interventions for the primary prevention of cardiovascular disease from inception to March 2021. References of included studies were also checked. The included systematic reviews\' methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 instrument (range, 0-16). The outcomes of each included review\'s meta-analysis were extracted and described narratively.
UNASSIGNED: This study analysed 95 systematic reviews, including 41 on non-pharmacological interventions and 54 on pharmacological interventions for cardiovascular health. The majority of the reviews focused on lipid-lowering interventions (n = 25) and antiplatelet medications (n = 21), followed by nutritional supplements, dietary interventions, physical activity, health promotion and other interventions. Only 1 of the 10 reviews addressing cardiovascular mortality showed a potential benefit, while the others found no effect. Antiplatelets were found to have a beneficial effect on all-cause mortality in 2 out of 12 meta-analyses and on major cardiovascular disease events in 8 out of 17 reviews. Lipid-lowering interventions showed beneficial effects on cardiovascular disease mortality, all-cause mortality and major cardiovascular disease events in varying numbers of the reviews. Glucose-lowering medications demonstrated significant benefits for major cardiovascular events, coronary heart disease events and mortality. However, the combination of dietary interventions, physical activities, nutritional supplements and polypills showed little or no significant benefit for major cardiovascular outcomes or mortality.
UNASSIGNED: More research is needed to determine whether the effect of treatment varies depending on population characteristics. The findings of this review should be interpreted with caution because the majority of studies of non-pharmacological interventions compare primary prevention with usual care, which may include recommended pharmacological treatment in higher-risk patients (e.g. statins and/or antihypertensive medications, etc.). In addition, randomised controlled trial evidence may be better suited to the study of pharmacological interventions than dietary and lifestyle interventions.
UNASSIGNED: This umbrella review captured the variability in different interventions on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease and identified areas that may benefit from further research. Specifically, this review focused on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease. Researchers may use these findings as a resource to direct new intervention studies and network meta-analyses to compare the efficacy of various interventions based on these findings.
UNASSIGNED: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme as award number 17/148/05.
Heart and blood vessel diseases are the top cause of death worldwide. This study aimed to compare the effectiveness of various drug-based and non-drug-based methods in preventing these diseases. We searched databases like Cochrane, MEDLINE, EMBASE and the Database of Abstracts of Reviews of Effects archive to find reviews about different ways to prevent heart and blood vessel diseases up until March 2021. The results showed that only 1 out of 10 reviews found a possible benefit in reducing heart-related deaths, while the other 9 found no effect. Medicines that lower blood sugar levels had a positive impact on reducing major heart events, heart disease and death. However, combining dietary changes, exercise, nutritional supplements and polypills had little or no effect on reducing heart-related events, deaths due to heart disease or deaths from all causes. This review examined the available evidence on ways to prevent heart and blood vessel diseases and identified areas where more research could be beneficial. Future studies could compare the effectiveness of different interventions using new methods and analyses.
摘要：
■心血管疾病是全球死亡的主要原因。本系统综述的目的是比较不同的药物和非药物干预措施对心血管疾病一级预防的有效性。
■对Cochrane系统评论数据库的结构化搜索，MEDLINE,进行了EMBASE和“效果评论摘要数据库”存档，以发现系统评论，这些评论报告了从开始到2021年3月对心血管疾病一级预防的各种药理和非药理干预措施的效果。还检查了纳入研究的参考文献。所包括的系统评价方法学质量是使用多重系统评价2工具(范围，0-16）。对每个纳入综述的荟萃分析的结果进行提取和叙述描述。
■本研究分析了95篇系统综述，包括41个关于非药物干预和54个关于心血管健康的药物干预。大多数评论集中在降脂干预（n=25）和抗血小板药物（n=21），其次是营养补充剂，饮食干预，身体活动,健康促进和其他干预措施。在针对心血管死亡率的10篇综述中，只有1篇显示出潜在的益处。而其他人没有发现任何效果。在12份荟萃分析中，有2份发现抗血小板对全因死亡率有有益作用，在17份综述中，有8份发现抗血小板对主要心血管疾病事件有有益作用。降脂干预对心血管疾病死亡率显示出有益的影响，不同数量的综述中的全因死亡率和主要心血管疾病事件.降糖药物对主要心血管事件有显著益处，冠心病事件和死亡率。然而,饮食干预的组合，身体活动,营养补充剂和息肉对主要心血管结局或死亡率几乎没有或没有显著获益.
■需要更多研究来确定治疗效果是否因人群特征而异。本综述的结果应谨慎解释，因为大多数非药物干预研究将一级预防与常规护理进行了比较。其中可能包括对高风险患者的推荐药物治疗（例如他汀类药物和/或抗高血压药物，等。).此外,随机对照试验证据可能比饮食和生活方式干预更适合药理学干预研究.
这篇综述记录了不同干预措施在心血管疾病一级预防干预措施的随机对照试验证据中的差异，并确定了可能从进一步研究中受益的领域。具体来说,本综述集中于心血管疾病一级预防干预措施的随机对照试验证据.研究人员可以使用这些发现作为指导新的干预研究和网络荟萃分析的资源，以比较基于这些发现的各种干预措施的有效性。
■本文介绍了由国家健康与护理研究所（NIHR）健康技术评估（HTA）计划资助的独立研究，奖励号为17/148/05。
心脏和血管疾病是全球死亡的首要原因。这项研究旨在比较各种基于药物和非药物的方法在预防这些疾病中的有效性。我们搜索了像Cochrane这样的数据库,MEDLINE,EMBASE和效果评论摘要数据库存档，以查找有关在2021年3月之前预防心脏和血管疾病的不同方法的评论。结果显示，10篇评论中只有1篇发现了减少心脏相关死亡的可能益处，而其他9人没有发现效果。降低血糖水平的药物对减少主要心脏事件有积极影响，心脏病和死亡然而,结合饮食变化，锻炼,营养补充剂和息肉对减少心脏相关事件几乎没有影响，死于心脏病或死于各种原因。这篇综述研究了预防心脏和血管疾病的现有证据，并确定了更多研究可能有益的领域。未来的研究可以使用新的方法和分析来比较不同干预措施的有效性。
■对Cochrane系统评论数据库的结构化搜索，MEDLINE,进行了EMBASE和“效果评论摘要数据库”存档，以发现系统评论，这些评论报告了从开始到2021年3月对心血管疾病一级预防的各种药理和非药理干预措施的效果。还检查了纳入研究的参考文献。所包括的系统评价方法学质量是使用多重系统评价2工具(范围，0-16）。对每个纳入综述的荟萃分析的结果进行提取和叙述描述。
■本研究分析了95篇系统综述，包括41个关于非药物干预和54个关于心血管健康的药物干预。大多数评论集中在降脂干预（n=25）和抗血小板药物（n=21），其次是营养补充剂，饮食干预，身体活动,健康促进和其他干预措施。在针对心血管死亡率的10篇综述中，只有1篇显示出潜在的益处。而其他人没有发现任何效果。在12份荟萃分析中，有2份发现抗血小板对全因死亡率有有益作用，在17份综述中，有8份发现抗血小板对主要心血管疾病事件有有益作用。降脂干预对心血管疾病死亡率显示出有益的影响，不同数量的综述中的全因死亡率和主要心血管疾病事件.降糖药物对主要心血管事件有显著益处，冠心病事件和死亡率。然而,饮食干预的组合，身体活动,营养补充剂和息肉对主要心血管结局或死亡率几乎没有或没有显著获益.
■需要更多研究来确定治疗效果是否因人群特征而异。本综述的结果应谨慎解释，因为大多数非药物干预研究将一级预防与常规护理进行了比较。其中可能包括对高风险患者的推荐药物治疗（例如他汀类药物和/或抗高血压药物，等。).此外,随机对照试验证据可能比饮食和生活方式干预更适合药理学干预研究.
这篇综述记录了不同干预措施在心血管疾病一级预防干预措施的随机对照试验证据中的差异，并确定了可能从进一步研究中受益的领域。具体来说,本综述集中于心血管疾病一级预防干预措施的随机对照试验证据.研究人员可以使用这些发现作为指导新的干预研究和网络荟萃分析的资源，以比较基于这些发现的各种干预措施的有效性。
■本文介绍了由国家健康与护理研究所（NIHR）健康技术评估（HTA）计划资助的独立研究，奖励号为17/148/05。
心脏和血管疾病是全球死亡的首要原因。这项研究旨在比较各种基于药物和非药物的方法在预防这些疾病中的有效性。我们搜索了像Cochrane这样的数据库,MEDLINE,EMBASE和效果评论摘要数据库存档，以查找有关在2021年3月之前预防心脏和血管疾病的不同方法的评论。结果显示，10篇评论中只有1篇发现了减少心脏相关死亡的可能益处，而其他9人没有发现效果。降低血糖水平的药物对减少主要心脏事件有积极影响，心脏病和死亡然而,结合饮食变化，锻炼,营养补充剂和息肉对减少心脏相关事件几乎没有影响，死于心脏病或死于各种原因。这篇综述研究了预防心脏和血管疾病的现有证据，并确定了更多研究可能有益的领域。未来的研究可以使用新的方法和分析来比较不同干预措施的有效性。
