Precision medicine aims to provide personalized clinical care guided by tools that reflect underlying pathophysiology. The need for such an approach has never been greater in cardiovascular medicine, given the large number of guideline-directed medical therapies available. However, progress has been modest to date with few precision tools available for clinicians. Arguably, cardiovascular prevention and population health are poised for innovation to guide evaluation and management, as these areas are already informed by risk-assessment, but limited by the use of crude assessment tools with marginal performance. Risk assessment in prevention and population health may be improved with the use of genetics, circulating biomarkers, and imaging, leading to outcome-specific risk-prediction and enhanced phenotyping. Personalized management matching therapy to risk profile can be then implemented for either individuals or groups, improving cost-effectiveness and risk-benefit. Here, we explore this precision-like approach, including available tools, potential applications, and future perspectives for cardiovascular prevention and population health management.

中文翻译：

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用于心血管预防和人口健康的精准医学：桥梁太远了？


精准医学旨在提供以反映潜在病理生理学的工具为指导的个性化临床护理。鉴于有大量指南指导的医学疗法可用，心血管医学对这种方法的需求从未如此强烈。然而，迄今为止，进展不大，临床医生可用的精确工具很少。可以说，心血管预防和人口健康已准备好通过创新来指导评估和管理，因为这些领域已经受到风险评估的指导，但受到使用性能边际的粗糙评估工具的限制。通过使用遗传学、循环生物标志物和影像学检查，可以改善预防和人群健康的风险评估，从而实现结果特异性风险预测和增强表型。然后可以对个人或群体实施个性化管理，将治疗与风险状况相匹配，从而提高成本效益和风险收益。在这里，我们探讨了这种类似精度的方法，包括心血管预防和人口健康管理的可用工具、潜在应用和未来前景。