编者按：第二十六届国际长城心脏病学会议的主题为“弥合裂痕，应对挑战”。事实上，心血管疾病防治多年来，技术和药物不断发展，为何发病人数依然不断上升。对此，美国心脏病学学会（ACC）主席Kim Williams指出，一级预防和二级预防之间裂痕弥合尤其重要。

　　International Circulation：The first question is about the conference. The conference called “bridging the gap， facing the challenge”. In your opinion， what is the main gap need to be bridged in the prevention control of cardiovascular disease?

　　弥合心血管疾病管理裂痕

　　Kim Williams: Like we said， we really would like to divide about what we are doing about the prevention into primary prevention and secondary prevention. There are people who don’t even find out that they have diabetes， hypertension or heart disease until they have an event. In that point， we are motivated to try to change， and we are motivated to help them to change. We gave them medications; we don’t know is that when with that strategy. There are numbers of patients taking that medicines after recognizing that they have the disease and those can only get the disease controlled; it is not what we need to be， none the three of them. So， the question is why can’t we do more about primary prevention? Why we don’t bring people’s attention before they have the high cholesterol， that they have pre-diabetes and diabetes? Then their blood pressure is optimized before it happens. And even before then， if we can start maybe in the childhood and change some of their habits. If we can really pick these three things fixed， that will be: how much physical activity do people have? What are the components of the diet such as high fat， high sugar， and high cholesterol being the most drive of the cardiovascular disease? And also， we should make sure that people are not smoking. If we can do those three things， there will be a world of differences. This meeting having me seeing the bridging the gap， which is ok. And it is really an important thing and it really placed on me an idea that， you know， there is a lot of motivation in China and other places to lowery the smoking rates. It is really something we need to across the world， not just here China and United States though.

　　心血管病管理的裂痕主要存在于一级预防和二级预防之间。很多患者在发生心血管事件之前几乎对自己患病一无所知。这个层面需医疗积极改变，不仅给患者处方药物，还应告知合适的用药时机。因大多数患者仅在意识到患病的情况下才服药，但只能控制病情，但这并不是理想治疗效果。因此一级预防层面值得做更多工作，在患者胆固醇水平升高前、患糖尿病前、高血压发作前控制血压，甚至教育儿童从改变生活习惯做起。平时做多少运动？饮食结构包含多少高脂肪、高糖、高胆固醇成分？是否吸烟？在疾病管理的第一道防线如做好这3件事，整个现状就会不同。

　　International Circulation: So more specifically about diet， can you show us more about the diet of heart disease patient， as well as good habit to prevent this?

　　良好的饮食结构习惯是关键

　　KM: We can start with two different ends in aspects of two of published literatures. So， you have the literature talked about what are the characteristics of people who lived to be hundred years old? Well， it turns out that they mostly plan basic nutrition. There is very little meat， maybe one small portion for 5 times per month， or none. And that really does make a difference. There is published data on just reducing the amount of meat， decreasing to no meat and just fish， decreasing to fish down to just dairy， and eliminate all animal products. And there are stairs step of fact that it turns out to reducing the obesity， hypertension and diabetes. Once we do that， the risk factors are gone and the development of heart disease that ends of death is reduced significantly. On the opposite end， you have data accumulating talking about the specific components of meat on saturated fat， fast glucose level， heam iron， inflammatory molecules such as C-reactive protein and trimethylamine oxide. All of which are accumulating inside the person who is eating the animal products instead of eating vegetables. So got that in the other hand， you have gotten fresh vegetables and everything from vital chemicals to vitamins to fiber; that is good for the body and preventing cardiovascular disease. So you have much lower blood pressures and much better insulin regulations when you on a plan based diet. So if we contrast of what we know about how bad the animal products are and how good the vegetable products are， we can get the conclusion that we probably should all do much more in turns of plan based nutrition， as well as doing more exercises and avoiding smoking. If we do these three things， if not eliminate the heart disease， we can make ourselves unbusy as cardiologists.

　　很多百岁老人都有基本的营养计划。比如饮食中肉类很少，每个月只进食5次甚至不进食肉类。有研究曾经对肉类饮食进行分析，推荐减少肉食摄入，只进食鱼类、乳制品，去除所有动物食品，可阶段性减少肥胖、高血压和糖尿病。相反方面也有研究对空腹血糖、炎性因子C反应蛋白和三甲胺氧化物水平进行分析，与进食蔬菜相比，进食富含饱和脂肪肉类的人群上述因子在体内不断聚集。这也说明进食蔬菜、必需维生素和纤维素对预防心血管疾病的获益，血压更低、胰岛素调节能力更好。在知晓动物性食品可能带来的疾病风险之后，有助于人们妥善安排自己的基础营养计划，再配合运动，杜绝吸烟，完善健康的生活方式，对心血管健康大有裨益。