编者按：大部分慢病是可以预防的，有共同的、可改变的行为危险因素，如吸烟、不健康饮食、活动不足和饮酒。这些危险因素导致超重和肥胖、血压升高以及胆固醇升高。因此，若要在2025年将慢病所致过早死亡率降低25%，必须有效减少心血管病及其风险因素。英国帝国理工学院国立心肺研究所David Wood教授指出，项目的最终目标是降低心血管死亡率。

　　International Circulation: I would like to ask you some questions about heart. The first question is: the World Heart Federation launched 25 by 25 program. Would you please tell us what is the 25 by 25 program， and why is it so important?

　　WHF 25×25计划及其实施现状

　　David Wood: So heads of States in 2011 met at the United Nations around topic of non-communicable disease， and they addressed this because this is the biggest disease burden of the world; and cardiovascular disease， heart attack and strokes account for the most of those deaths due to the non-communicable diseases. And they agreed to reduce the burden of non-communicable diseases worldwide， and WHO targeted of a 25% reduction in premature mortality from non-communicable diseases by 25. And that is the 25 by 25 expression. And if the target to be achieved， we can only be achieved with reduction in cardiovascular mortality.

　　So the World Heart Federation’s mission is to reduce the burden of cardiovascular disease to prevent this disease， and manage more effectively. And the World Heart Federation has chosen to focus on secondary prevention of cardiovascular disease， hypertension prediction and control， and finally tobacco control. The reason for that is because if we are successful in secondary prevention in hypertension treatment， in reducing exposure of tobacco. We will get towards about 80% of that 25% reduction in premature mortality. Just by focusing onthose three areas and those are the priorities of the World Heart Federation.

　　鉴于非传染性疾病已成为全球最大的疾病负担，2011年各国首脑在联合国会晤时就如何应对非传染性疾病进行了探讨。人们认识到，在非传染性疾病中，心血管疾病、心肌梗死及卒中是最主要的死亡原因。最终，大家共同制定了到2025年将非传染性疾病所致的过早死亡发生率降低25%的努力目标，即25×25计划。要实现上述目标，首要任务是降低心血管疾病的死亡率。

　　世界心脏联盟（WHF）的使命是积极预防并更有效地管理心血管疾病，以减少心血管疾病负担。鉴于对高血压积极二级预防和减少烟草暴露可显著降低过早死亡率，故一直以来，WHF都在努力优先关注和开展心血管疾病的二级预防、高血压的预测控制以及控烟。

　　International Circulation: And what are the main challenges we are facing in achieving those program?

　　WHF 25×25计划面临的挑战

　　DW: So the challenges are huge. For patients who already have developed vascular disease， we are eligible for secondary prevention and rehabilitation. Only minority of those patients are receiving evidences based had treatments， and there is enormous heterogeneity in the use of such treatment worldwide progressively falling to middle or to low income countries. So that represents a very considerable challenge. So to the detection and treatment of hypertension， many people with raised the blood pressure do not know it; or they do not have their blood pressure measured; or their blood pressure has been measured， but the diagnosis of hypertension has not been made; or if the diagnosis of hypertension has been made， they are not effectively treated as they should be. So this represents another big challenge for primary prevention of cardiovascular disease. For the tobacco， there has been a great progress through the framework conventional tobacco control and bring it out a tobacco-free societies. But even though， there are many parts of the world are tobacco-high， especially in middle and low income countries， and that is the challenge as well.

　　For those who have already developed heart disease， the acute management of the disease is a challenge. The acute management of coronary artery disease in terms of thrombolysis and primary angioplasty， and prescribing the appropriate life-saving drugs is a challenge in many parts of the world. Beyond that， for those who are survived from acute event， there is an even bigger challenge of addressing the underline causes of the disease. And that require life style changes， require smoking cessation and adoption a health adapt， becoming more physical actively. That represent a very big challenge for individuals as well as for populations.

　　该计划目前面临巨大挑战，首先是心血管疾病一级预防形势严峻。高血压知晓率、治疗率及控制率较低；控烟方面虽已取得显著进步，各国都在努力创建无烟社会，但很多国家及地区尤其是中低收入国家的控烟形势仍面临较大挑战。对已罹患心血管疾病的患者需积极进行二级预防和康复，但仅少数接受了基于临床医学证据的治疗，全球各地治疗及管理情况存在很大异质性。此外，很多国家及地区的心血管疾病急性期管理及后续生活方式干预也不如人意。