H型高血压优化防治方案.ppt

* * * 2007年 我国脑卒中发病率不断上升 亚太NO1 2020年 脑卒中 180万/年 脑卒中发病 将达370万/年 8.7%/年 Zhao et al, Stroke, 2008 (国际“卒中”杂志上发表的中国-MONICA-北京调查结果 ) 东西方心脑血管疾病分布差异 AHA Heart Disease and Stroke Statistics -2009 update Report on CVD in China 2006 Fourth National Survey on Health Service /publicfiles 患病例数（百万） NOTES: Estimates are age-adjusted. Starting with 1999 data,causes of death were coded according to ICD–10. SOURCE: CDC/NCHS, National Vital Statistics System. Chartbook Health, United States, 2008 冠心病和脑卒中死亡率趋势及中美比较 Stroke 1950 1960 1970 1980 1990 2000 2005 Year 10,000 100 10 Deathsper100,000population(logscale) Heart disease 1985 1990 1995 2000 2005 Year 150 100 0 Mortality(1/100000) 50 USA Lisheng Liu, Cardiovascular diseases in China, Biochem. Cell Biol. 85: 157–163 (2007) Stroke CHD 138 54 211.1 46.6 China Asian Pacific Region Stroke (2002) 127.6 105.9 97.3 72.6 68.4 65.5 57.0 56.3 43.2 42.4 41.0 39.9 31.0 0 20 40 60 80 100 120 140 China Japan South Korea Vietnam Myanmar Laos Indonesia USA Cambodia Malaysia Singapore Thailand Philippines Incidence per 100,000 Atlas of Heart Disease and Stroke. MacKay J Mensah G. 2004. Geneva. WHO Figures (not adjusted for age). Stroke is more common than MI in Hypertension --Analysis based on 11 Major Randomized Intervention Trials STOP-1 SHEP STONE* SYST-EUR SYST-CHINA* HOT CAPPP STOP-2 NICS* NORDIL INSIGHT 1991 1991 1996 1997 1998 1998 1999 1999 1999 2000 2000 76 72 67 70 67 61 53 76 70 60 67 1627 4736 1632 4695 2394 18790 10985 6614 414 1088 6575 82 269 52 124 104 294 340 452 20 355 141 53 165 4 78 16 209 327 293 4 340 138 Year of Publication Average age (yrs) No.patients randomized No. strokes Study Acronym Total 2233 1627 1.37 Blood Pressure 2001; 10: 190-2 * Studies were conducted in China * Study was conducted in Japan Stroke:MIratio 1.54 1.63 13.00 1.58 6.56 1.41 1.04 1.54 5.00 1.04 1.02 No. MI 传统”三高”无法解释中国脑卒中高发现象 高血压 脑卒中 危险因素 高血脂 高血糖 潜伏的答案——HCY 对比观察 美国 中国 脑卒中年发病