Abstract：
Atherosclerotic cardiovascular disease (ASCVD) remains the major cause of premature death and disability; effective cardiovascular (CV) risk prevention is fundamental. The World Heart Federation (WHF) Cholesterol Roadmap provides a framework for national policy development and aims to achieve ASCVD prevention. At the invitation of the WHF, a group of experts from the Portuguese Society of Cardiology (SPC), addressed the cholesterol burden at nationally and discussed possible strategies to include in a Portuguese cholesterol roadmap. The literature review showed that the cholesterol burden in Portugal is high and especially uncontrolled in those with the highest CV risk. An infographic scorecard was built to include in the WHF collection, for a clear idea about CV risk and cholesterol burden in Portugal, which would also be useful for health policy advocacy. The expert discussion and preventive strategies proposal followed the five pillars of the WHF document: awareness improvement; population-based approaches for CV risk and cholesterol; risk assessment/population screening; system-level approaches; surveillance of cholesterol and ASCVD outcomes. These strategies were debated by all the expert participants, with the goal of creating a national cholesterol roadmap to be used for advocacy and as a guide for CV prevention. Several key recommendations were outlined: include all stakeholders in a multidisciplinary national program; create a structured activities plan to increase awareness in the population; improve the quality of continuous CV health education; increase the interaction between different health professionals and non-health professionals; increment the referral of patients to cardiac rehabilitation; screen cholesterol levels in the general population, especially high-risk groups; promote patient self-care, engage with patients\' associations; use specific social networks to spread information widely; create a national database of cholesterol levels with systematic registry of CV events; redefine strategies based on the evaluation of results; create and involve more patients\' associations - invert the pyramid order. In conclusion, ASCVD and the cholesterol burden remain a strong global issue in Portugal, requiring the involvement of multiple stakeholders in prevention. The Portuguese cholesterol roadmap can provide some solutions to help urgently mitigate the problem. Population-based approaches to improve awareness and CV risk assessment and surveillance of cholesterol and ASCVD outcomes are key factors in this change. A call to action is clearly needed to fight hypercholesterolemia and ASCVD burden.
摘要：
动脉粥样硬化性心血管疾病（ASCVD）仍然是过早死亡和残疾的主要原因；有效的心血管（CV）风险预防是根本。世界心脏联合会（WHF）胆固醇路线图为国家政策制定提供了框架，旨在实现ASCVD的预防。应WHF的邀请，一组来自葡萄牙心脏病学会（SPC）的专家，解决了国家层面的胆固醇负担问题，并讨论了将其纳入葡萄牙胆固醇路线图的可能策略。文献综述显示，葡萄牙的胆固醇负担很高，尤其是心血管风险最高的人群。一个信息图表，记分卡,被构建为包含在WHF集合中，关于葡萄牙的CV风险和胆固醇负担，这对卫生政策宣传也很有用。专家讨论和预防策略提案遵循了WHF文件的五个支柱：提高认识；基于人群的CV风险和胆固醇方法；风险评估/人群筛查；系统级方法；胆固醇和ASCVD结果的监测。所有专家参与者都对这些策略进行了辩论，目的是制定国家胆固醇路线图，用于宣传和指导CV预防。提出了一些关键建议：将所有利益相关者纳入多学科国家计划；制定结构化的活动计划，以提高人们的认识；提高连续CV健康教育的质量；增加不同卫生专业人员与非卫生专业人员之间的互动；增加患者接受心脏康复的转诊；筛查普通人群中的胆固醇水平，特别是高危人群；促进患者自我护理，与患者联系；使用特定的社交网络广泛传播信息；创建具有CV事件系统注册表的国家胆固醇水平数据库；根据结果评估重新定义策略；创建并涉及更多的患者协会-颠倒金字塔顺序。结论：ASCVD和胆固醇负担在葡萄牙仍然是一个强烈的全球性问题，要求多个利益相关者参与预防。葡萄牙胆固醇路线图可以提供一些解决方案，以帮助紧急缓解这一问题。基于人群的方法来提高认知和CV风险评估以及胆固醇和ASCVD结果的监测是这种变化的关键因素。显然需要采取行动来对抗高胆固醇血症和ASCVD负担。
