最新高血压指南的几个问题 整理.ppt

最新高血压指南的几个问题 刘力生 内容提要 关于血压水平的定义和分类 关于危险度分层 关于卫生经济学 关于用药问题 高血压患者危险分层--WHO/ISH 1999 影响高血压患者预后的因素 高血压患者危险分层--2003欧洲高血压指南 血压分类--JNC-VI(1997) --------------------------------------------------------- 类 别 收缩压（mm Hg) 舒张压（mm Hg) --------------------------------------------------------- 理想血压 120 80 正常血压 120 - 129 80 - 84 正常高值 130 - 139 85 - 89 1级高血压 140 – 159 90 – 99 亚组：临界高血压 140 - 149 90 - 94 2级高血压 160 - 179 100 -109 3级高血压 ?180 ?110 单纯收缩期高血压 ?140 90 亚组：临界收缩期高血压 140 - 149 90 --------------------------------------------------------------- 1. Distribution of NHANES I Epldemiologic Follow-up Study Participants with a High-Normal BP or Hypertension at Baseline According to BP Lovel and Risk Categorization 2. Estimated Effect of a 12mmHg Reduction in SBP Over 10 years on the Number-Needed-to-Treat to Prevent a Cardiovascular Disease Event Among NHANES I Epidemiologic Follow-Up Study Participants According to Baseline BP Level and Category of Presumed Cardiovascular Risk 3. Estimated Effect of a 12mmHg Reduction in SBP Over 10 years on the Number-Needed-to-Treat to Prevent a Cardiovascular Disease Death Among NHANES I Epidemiologic Follow-Up Study Participants According to Baseline BP Level and Category of Presumed Cardiovascular Risk 4. Estlmated Effect of a 12mmHg Reduction in SBP Over 10 years on the Number-Needed-to-Treat to Prevent An AI-Cause Death Among NHANES I Epidemiologic Follow-Up Study Participants According to Baseline BP Level and Category of Presumed Cardiovascular Risk 不同危险程度高血压患者的血压水平(mmHg, x?s) 男 女 危险度 SBP DBP SBP DBP 低危 141.3(12.0) 88.7(7.9) 141.7(10.8) 88.4(10.1) 中危 144.7(15.6) 89.3(9.7) 144.1(26.7) 86.4(10.6) 高危 144.0(17.7) 88.8(11.5) 139.6(18.6