高血压和饮食.pptVIP

主要来自肾脏的肾素，把肝脏产生的血管紧张素原转化为血管紧张素I，后者再在血管紧张素转化酶的作用下转化为血管紧张素II（AngII），然后通过组织中受体而发挥作用。血管紧张素II对人体正常血压的维持有着非常重要的作用，是人体必不可少的重要生物物质，然而其生成过多却会引起一系列病变。当其作用血管壁，将会致血管硬化、狭窄、闭塞，继而引起血压升高、视网膜脱落、脑中风、肾小球硬化等；当其作用于心脏，将会导致心梗、心衰的发生；当其作用于中枢神经系统时，将会引起机体体液电解质代谢的平衡，加重心、肾的负担。目前常用的拮抗血管紧张素II的药物有血管紧张素转换酶抑制剤（ACEI）和血管紧张素II受体抑制剂（ARB）两种。 * * ATCH：促肾上腺皮质激素。是由脑垂前叶分泌的激素，它能促进肾上腺皮质的组织增生以及皮质激素的生成和分泌。 儿茶酚胺是指多巴胺、去甲肾上腺素和肾上腺素。这三种儿茶酚胺都是由络氨酸结合。 ADH：抗利尿激素 * SMC：动脉中膜的血管平滑肌细胞 * * * * * * * 从肾脏外观上我们就可以看到高血压对肾脏的损害。 正常肾脏表面是光滑的 高血压患者由于肾小球硬化，在肾脏表面形成特征性的颗粒状 * * Epidemiologic research has shown that hypertension usually occurs in conjunction with other CV risk factors. Data from the Framingham study clearly illustrate the co-existence of risk factors in the hypertensive population. In the Framingham population, 20% of hypertension cases occurred in isolation. Most patients (73% in men and 71% in women) had between 1 and 3 risk factors for CV in addition to hypertension. A further 8% and 12% of men and women, respectively, had 4 or more additional risk factors for CVD. * Using data from the Multiple Risk Factor Intervention Trial (MRFIT), Neaton and colleagues examined the interaction between TC levels, SBP, smoking, and CHD death rates. Note the strong, graded relationship between increasing cholesterol levels and CHD death across SBP levels and the similarly strong relationship between small increases in SBP and CHD death across TC levels. When risk factors are analyzed together, patients in both the highest TC and the highest SBP quintiles had an approximately 11-fold greater risk of CHD death than patients who were in both the lowest TC and the lowest SBP quintiles. * Emberson J et al, used estimates of the relative risk reductions from meta-analyses of randomised trials in combination with data from a prospective observational study of CVD (the British Regional Heart Study) to analyse the impact of different risk reduction strategies in primary prevention. The study examined the effects of prevention strategie