高血压药物的合理应用材料.ppt

Wolf-Maier et al.,的研究中，数据来源国家和地区（欧洲和北美地区比较），数据简单进行了不同年龄、性别包括BP ≥140/90 mmHg或正在服用抗高血压药物患者的高血压流行病学分析。 流行病学数据显示美国和加拿大高血压发病率是相似的 (28% and 27%, 加拿大的数据幻灯片没有显示), 但是欧洲国家明显高 (平均44.2%). Reference Wolf-Maier K, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 2003;289:2363–9. * 前瞻性队列研究纳入了我国19个省市40岁以上的受试者169871例，1991年开始收集包括血压、血脂等在内的基线数据，并于1999-2000年进行随访评估。过早死亡定义为死亡年龄小于2005年我国人群平均寿命（男性72岁，女性75岁）。该研究应用2005年我国人群归因危险、死亡率及人口规模来计算总死亡人数和过早死亡人数。 结果显示，高血压、高血压前期与全因死亡率及心血管死亡率增加明显相关（p0.0001）。研究者估计我国2005年共233万人因高血压过早死亡，其中22万人因高血压前期所致。脑血管疾病所致相关死亡占很大比例。 A prospective cohort study in a nationally representative sample of 169?871 Chinese adults aged 40 years and older. Blood pressure and other risk factors were measured at a baseline examination in 1991 and follow-up assessment was done in 1999–2000. Premature death was defined as mortality before age 72 years in men and 75 years in women, which were the average life expectancies in China in 2005. We calculated the numbers of total and premature deaths attributable to blood pressure using population-attributable risk, mortality, and the population size of China in 2005 Raised blood pressure accounted for 1,395,400 (1,332,300–1,458,600) cardiovascular deaths in men (135,000 [117,300–152,700] in prehypertensives and 1,260,400 [1,215,000–1,305,900] in hypertensives) and 935,100 (878,800–991,300) in women (82,600 [68,800–96,400] in prehypertensives and 852,500 [810,000–894,900] in hypertensives) (figure 1A). Of these deaths, 784?200 (731,700–836,800) premature cardiovascular deaths in men (76,300 [62,400–90,200] in prehypertensives and 707,900 [669,200–746,500] in hypertensives) and 483,800 (444,100–523,400) in women (45,300 [36,200–54,400] in prehypertensives and 438,500 [407,900–469,000] in hypertensives) were attributable to increased blood pressure (figure 1B). Most blood pressure-related total deaths (1,076,000 [1,024,100–1,127,900] in men and 786,100 [740,600–831,500]