— 健康促進與維護 · MEDIUM · MCQ —
一位 55 歲患有多項心血管疾病（CAD）風險因子的個案，詢問生活型態介入。何者是一級預防最有效的介入？
A 55-year-old client with multiple risk factors for coronary artery disease (CAD) asks about lifestyle interventions. What is the most effective intervention for primary prevention?
- ATaking a daily multivitamin每日服用綜合維生素
- BSmoking cessation✓ 正解戒菸
- CEating exclusively organic foods僅食用有機食品
- DAvoiding all stress-inducing activities避免所有會引起壓力的活動
— Explanation · 中文詳解 —
吸菸是心血管疾病最重要的可調控危險因子。戒菸能直接降低冠狀動脈阻塞的風險，對心血管系統的保護作用遠超其他選項。多種維生素對 CAD 的預防證據力不足，完全避開壓力不切實際，而飲食僅需均衡即可，有機食品與否並非疾病預防的核心關鍵。
Smoking is the most important modifiable risk factor for coronary artery disease. Cessation directly reduces the risk of vessel obstruction and improves endothelial function, providing greater cardiovascular protection than any of the other options. Multivitamins have insufficient evidence; total avoidance of stress is impractical; organic foods alone do not specifically prevent CAD.
✦ 台美臨床差異
台灣針對戒菸有成熟的健保門診輔助與藥物支持，美國則強調護理師主導的動機式晤談。