脑血管病血压管理策略分析.ppt

* * 这张幻灯的数据来自1990年世界卫生组织的报告，可以看到，脑血管病是仅次于缺血性心脏病的全球第二大致死性疾病，从1990年到今天，脑血管病依然是全球第二大致死性疾病，但是其致残性却位列第一。 北京地区新数据表明脑血管病死因占第二位，第一位是恶性肿瘤，而肿瘤中第一位是肺癌 * 而我国除了人口总数世界第一以外，也是一个名副其实的卒中第一大国。在我国，每年新发卒中患者超过200万，因卒中死亡165万人，居世界首位。在北京与上海，卒中的发病率高达135与76/10万人，在长沙卒中发病率更高，达到150人/10万人。我国每年因卒中死亡的人数也远远超过印度和俄罗斯，每年因卒中死亡人数高达165万，是排名第二的印度的两倍！ Background and Purpose—To examine the incidence and trends of stroke and its major subtypes during the 1990s in 3 cities in China. Methods—Stroke cases registered between 1991 to 2000 were initially identified through the stroke surveillance networks established in Beijing, Shanghai, and Changsha, and then confirmed by neurologists. Results—The age-standardized incidence rates per 100 000 person years of overall first-ever stroke were 135.0 (95% CI, 126.5 to 144.6) in Beijing, 76.1 (70.6 to 82.6) in Shanghai, and 150.0 (141.3 to 160.0) in Changsha during the 1990s. Incidence of ischemic stroke (IS) was highest in Beijing, followed by Changsha and Shanghai; for intracerebral hemorrhage (ICH), the highest rate was found in Changsha, followed by Beijing and Shanghai. The same order as ICH was also observed for subarachnoid hemorrhage. The age-adjusted incidence of overall stroke and ICH for individuals 55 years of age in our populations was generally higher than that from Western populations. During the 1990s, ICH incidence decreased significantly at a rate of 12.0% per year in Beijing, 4.4% in Shanghai, and 7.7% in Changsha; in contrast, except for Changsha, IS incidence increased in Beijing (5.0% per year) and Shanghai (7.7%). Conclusions—There is a geographic variation in the incidence of stroke and its subtypes among these 3 cities, but the incidence of overall and hemorrhagic stroke in China is generally higher than that in the Western countries. Interestingly, the decrease in ICH and increase in IS during the past decade may reflect some underlying changes of risk factors in Chinese populations. (Stroke. 2006;37:63-68.) 我国的预防脑卒中复发研究，即Press－China研究的结果提示，我