高血压与冠心病健康管理.ppt

Reference: 1. Criqui MH et al. N Engl J Med 1992; 326: 381–6. Only 1 in 10 patients with PAD has classical symptoms of intermittent claudication The GetABI study shows that the prevalence of PAD in a typical unselected sample of patients in a primary care setting is substantial. On average, about every fifth unselected patient (age-adjusted prevalence 19.8%) in primary care has an ABI 0.9, indicating generalized atherothrombosis. Sensitivity of diagnosis – proportion of PAD patients in whom PAD is detected correctly by means of the WHO Intermittent Claudication (IC) questionnaire – was 11.1% when using the ABI as a yardstick against which the questionnaire was completed. Reference: Diehm C et al. High prevalence of PAD and co-morbidity in 6880 primary care patients: cross sectional study. Atherosclerosis 2004; 172; 95–105. The American Diabetes Association recommends screening for PAD in patients with diabetes In patients with type 2 diabetes, peripheral arterial disease (PAD) is a major contributor to diabetic foot problems. Common foot problems include loss of feeling in feet, changes in the shape of feet, infection, ulceration, or gangrene that may lead, in severe cases, to amputation of a toe, foot or leg. Further, prevention of foot problems may be easier than treating foot problems. 动脉粥样硬化是一个慢性的炎症过程，炎症驱动着动脉粥样硬化的发生和进展。遗传因素是导致动脉粥样硬化的一个重要因素，除此之外还有许多的危险因素共同推动着动脉粥样硬化的进展，这些危险因素导致血管内皮功能异常，从而引发炎症，炎症又引发动脉粥样硬化。在众多的危险因素中，低密度脂蛋白胆固醇(LDL-C)是最重要的一个危险因素。 Key Point Smoking is causally linked to a host of cardiovascular, respiratory, reproductive, and other conditions, as well as many types of cancer. The top 3 smoking-attributable causes of death in the United States are lung cancer, ischemic heart disease, and chronic obstructive pulmonary disease (COPD). Background In 2004, the US Surgeon General published a report on the health effects of active smoking, focusing specifically on the evidence for a causal relationship between smoking and disease and d