编者按：改善心血管疾病流行现状的关键在于预防及管理，要积极进行生活方式干预、戒烟、合理膳食、坚持运动并保持适当体重。AHA前任主席、美国北卡洛琳娜大学医学院Sidney C. Smith教授指出，要想遏制心血管疾病的流行，首先要在社区广泛开展生活方式项目，预防心血管疾病发生；其次，需确保已有心血管疾病的患者坚持健康生活方式及所需药物治疗。

　　International Circulation: I will ask some questions about heart disease in China. Firstly I would like to ask you about the key elements of improvement of people with heart disease. Would you like to introduce that to the audience and platform， and share more about this program?

　　中国心血管管理项目

　　SS: Well， the foundation of improving heart disease is to prevent it， and also for taking care of it when you have heart disease life style. You should not smoke cigarettes， you should eat right diet， maintain the right weight， and I think it is very important is exercise. So we have two things we need to do: the first is to prevent it from the occurring in that basically a broad life style program in the community; and secondly， for patients who are already have heart disease， being sure that they do have a healthy life style， and then they take the medications they need， such as aspirin，statin and other medications.

　　We are very excited about the Chinese cardiovascular care program， it was initiated in September of 2014， and it a collaborated project which involved Chinese Society of Cardiology on the leadership of Yang， the American Heart Association and Administration of Health. It is a quality improvement program where we are working with hospitals to be sure that patients get the right medication and right recommendation of therapy when they come in with heart disease. We are looking into two projects now， one is with heart attack， and the other one is with atrial fibrillation， an in-rhythmy of heart beat; to be sure that Chinese patients come in to the hospitals get the right treatment and the recommended treatment. Now we have 150 hospitals are participating， so it is not every hospital in China. But we expected to expand at the last meeting in Shanghai， just one year after the starting we gave a word to 70 hospitals in China for their excellence and improvements in using guidelines therapy. It is a very exciting program， and I think it has potential to have patient care in China.

　　该项目是质量改进项目，由中国心脏病学会与美国心脏病协会联合举办，始于2014年9月，旨在确保心脏病患者能得到正确的治疗推荐。目前，共计150家医院参加了该项目。项目实施1年后，有70家医院因应用指南推荐的治疗取得卓越成绩和显著改进而得到表彰。该项目的实施有望改善中国患者管理。

　　International Circulation: And you also talked about ACS in China; there are quite a lot differences between American and China in ACS patient， right?

　　中美冠心病现状差异

　　SS: Well， we are very interested to look at the heart patient in ACS stenting patients that come in. In China， what we see are younger patients who have the STEMIwith big heart attack， in United States， most heart attack patients are older， and they have non-STEMI with smaller heart attack. Now I am quite interested in why young people in China are more gain big heart attack. So one reason is that in United States， we have primary prevention， so many patients will start on stand in aspirin， and I think that blanch the size of the heart attack. Whereas in China， if you smoking cigarettes and have high blood pressure， it will be not treated. We call it “sitting duck”， they are just waiting to have a heart attack. So when they have it， it will be a big one. That is my theory on the younger age group and bigger heart attack in China.

　　中国急性冠状动脉综合征（ACS）患者通常更年轻，多为ST段抬高心肌梗死患者，发作症状较严重；而美国ACS患者通常年龄更高，多为非ST段抬高心肌梗死患者，发作症状相对较轻。这可能与美国一级预防工作开展较好，很多患者从一级预防就接受阿司匹林治疗有关，而中国高血压和吸烟患者从未及时接受治疗。

　　International Circulation: So what would you like to say to doctors and people in China about health， especially the heart health?

　　关注中国心血管健康

　　SS: Well， I think， firstly I like to say to doctors don’t ask your patients to do something that you are unwilling to do yourselves. A doctor should not smoke， a doctor should exercise， a doctor should eat heart healthy diet， and a doctor should watch their weight. If the patients see a doctor walking around with overweight， smoking cigarettes， eating bad food， the patient are less willing to do it themselves. They will say “why the person who tell me to do it， but they don’t do it?” So the medical community is that the doctor must set an example. And then I think the community in general that we need to educate our children that “you have the right to choose a heart healthy life style”， you should not be like someone force some bad life style on you. If I sell you unhealthy food， then I will try to sell you the cigarettes. And I think educating children about what a heart healthy life style is so important， and getting the word out to the community. And I think the program as it says， where you are very good communicators and getting through video ideas the community are essential. Education is one of the biggest gifts we have in our life.

　　要想改善中国心血管健康，医生首先要从自身做起，积极戒烟、运动、坚持健康饮食、保持合理体重，为患者树立榜样。此外，心血管健康要从儿童抓起，对儿童进行心脏健康生活方式的教育，坚持健康生活方式。另外，社区层面的心脏健康生活方式教育也至关重要。