高血压联合用药解析.pdf

高血压联合用药组方原则与评价 高血压联合用药组方原则与评价 国家卫生部 国家卫生部 全国合理用药监测网 全国合理用药监测网 孙忠实 孙忠实 人类死因第一位是心血管疾病 人类死因第一位是心血管疾病 Global mortality from chronic diseases Global mortality from chronic diseases 2 WHO:每年死亡1700万(2010) JAMA 2004; 291 (21): 2616-22 2025年高血压发病率将再增60%! 2025年高血压发病率将再增60%! 3 WHO:人类死因的主要危险因素(2000) WHO:人类死因的主要危险因素(2000) *平均缩短寿命5年 4 SBP/DBP与CAD死亡率 SBP/DBP与CAD死亡率 (MRFIT) (MRFIT) 5 高血压治疗的获益 高血压治疗的获益 • Younger than 60 – reduces the risk of stroke by 42% – reduces the risk of coronary event by 14% • Older than 60 – reduces overall mortality by 20% – reduces cardiovascular mortality by 33% – reduces incidence of stroke by 40% – reduces coronary artery disease by 15% 6 老年高血压治疗的获益 老年高血压治疗的获益 • Older than 60 with isolated systolic hypertension (SBP ≥160 mm Hg and DBP 90 mm Hg) – 36% reduction in the risk of stroke – 25% reduction in the risk of coronary events Ref: adapted from SHEP, SYST-EUR, STONE studies. 2008 Canadian Hypertension Education Program (CHEP) 7 高血压治疗的获益 高血压治疗的获益 8 Classes of An