高血压合并多重危险因素及靶器官损害患者的治疗指南葛世俊PPT.ppt

Hypertension. Over one-fourth (27.4%) of respondents to the 1996 BRFSS reported they had been diagnosed with hypertension. Of these, 30.4% reported no other CVD risk factors. Twenty-four percent (24.0%) of hypertensives also reported a physically inactive lifestyle, while 15.1% were both obese and physically inactive in addition to having hypertension. In all, 26.9% of hypertensives reported two other CVD risk factors; 2.9% reported all four. Figure 2.18 on the following page presents the breakdown of persons with hypertension and the other CVD risk factors. Abstract—To evaluate the risk of cardiovascular disease (CVD) mortality in hypertensive men according to the presence of associated risk factors (ARFs). The population was composed of 29 640 normotensive men without ARFs (reference group) and 60 343 hypertensive men (with and without ARFs) who had a standard health checkup at the Centre d’Investigations Préventives et Cliniques between 1978 and 1988. Mortality data for a mean period of 14 years were analyzed. The following ARFs were considered: total cholesterol $2.5 g/L, personal history of diabetes, smoking (current smokers), body mass index .28 kg/m2, and heart rate .80 bpm. CVD risk related to the presence of isolated hypertension (assessed in hypertensive subjects without ARFs versus the reference group) increased linearly from 15% at the age of 30 years to 134% at the age of 80 years. In hypertensive subjects, one additional ARF increased CVD risk by 56% (47% to 65%, P,0.01) in younger subjects but only by 4% (28% to 17%, P5NS) in older subjects. The role of hypercholesterolemia and tobacco smoking in CVD mortality was significantly higher in hypertensive subjects aged ,55 years than in hypertensive subjects aged $55 years (P,0.01), whereas the roles of tachycardia and obesity were not affected by age. In younger hypertensive subjects, evaluation of CVD risk and therapeutic strategies should target ARFs. In older subjects, the presence of high blood pre