心脑血管病的防治-2015714.ppt

2、2002-2011年冠心病和急性心肌梗死死亡率变化趋势 2002-2011年冠心病和急性心肌梗死亡率总体上呈现上升态势，冠心病死亡率城市高于农村。农村居民从2005年开始，急性心肌梗死亡率呈现快速上升趋势，至2011年已连续3年超过城市居民的死亡率水平。见图2、3。 3、急性心肌梗死年龄别死亡率 急性心肌梗死死亡率随年龄的增加而增加，40岁开始显著上升，其递增趋势近似于指数关系。无论城市、农村，男性或女性，2002-2011年各年度数据均可发现上述现象。见图4、5、6、7。 高脂血症的危害？ 谢谢聆听! * * 首先看降压治疗的益处，近三四十年来，很多临床试验已经证实，当收缩压降低10–12mmHg或舒张压降低5-6mmHg（这两者在同一人群里往往是并行的），可以使以脑卒中和心肌梗死为主的心脑血管疾病明显下降。上图显示了当收缩压降低10–12mmHg或舒张压降低5-6mmHg时心力衰竭、脑卒中、心脑血管的死亡率、致死或非致死的冠心病事件的下降情况。 * In the UKPDS (United Kingdom Prospective Diabetes Study) a 1% decrease in HbA1c was estimated to correspond with significant reductions in any diabetes-related endpoint, diabetes-related death, all-cause mortality, myocardial infarction, stroke, peripheral vascular disease, microvascular disease and cataract extraction.1 UKPDS 35 was a prospective observational study to determine the relationship between exposure to hyperglycaemia over time and the risk of macrovascular or microvascular complications in patients with type 2 diabetes who were participants in the UKPDS.1 3642 white, Asian-Indian and Afro-Caribbean UKPDS patients who had HbA1c measured 3 months after their diabetes diagnosis and with complete data for potential confounders were included in the sub-analysis of relative risk. Reductions in the risk of microvascular and macrovascular complications that might be achieved by lowering HbA1c by 1% were estimated.1 The incidence of clinical complications was found to be significantly associated with hyperglycaemia. While any reduction in HbA1c is likely to reduce the risk of complications, the lowest risk was observed in those with HbA1c values in the normal range (6.0%).1 Stratton IM, et al. BMJ 2000;321:405–412. 心脑血管病的源头-危险因素 糖尿病 高血压 高血脂 三高 中国高血压的流行情况 54% 我国高血压患病率（＞15岁的人群） 高血压患病率% * 血压水平的定义和分类（2010） 类别　　　　　　　　 收缩压（mmHg）???????? 舒张压（mmHg） ―――――――――――――――――――――――――――――――――――　　　　　　　　　　　　　　　　正常血压 ＜120??????? 和 ＜80 正常高值