卒中与高血压PPT.ppt

However, according to the hypertension sampling investigation carried out in 1991, it is estimated that 94,000,000 patients suffered from hypertension in China, while in the epidemiological survey on the population aged between 35 and 74 years, conducted by Asian International Cooperation on Cardiovascular Research during 2000-2001, about 130,000,000 Chinese are inflicted with hypertension, that is to say, one in ten is found to be affected by hypertension. Control rate of hypertension only accounts for 8.1% of all patients, which barely amounts to a quarter of United States’s. Stroke mortality rate in each decade of age versus usual blood pressure at the start of that decade Risk of stroke against usual systolic blood pressure by age group * * 所有ASCOT预先设定的15个终点和2个事后分析结果显示，在预先设定的15个终点中有10个终点其 p值小于 0.05 ，都有利于络活喜?为基础的新型降压药物联合方案，而没有一个终点有利于甚至倾向于以阿替洛尔为基础的传统降压药物联合方案。新型降压药物联合方案全面胜出传统降压药物联合方案。 更值得一提的是，ASCOT研究是活性药物对照的大型临床研究中首次出现总死亡率的显著差异。 这无疑与络活喜?为基础的降压联合方案的早期和持久血压控制能力更加出色有关。 * * * * 让我们看一下ACCOMPLISH试验主要终点以及2组联合用药与各个终点的关系。 复合 CV发病率/死亡率 0.80 心血管死亡率0.81 非致死性心梗0.81 非致死性中风0.87 不稳定心绞痛入院0.74 冠脉血管成形术0.85 因猝死行复苏治疗1.75 除因猝死行复苏治疗支持使用ACEI / HCTZ组外，其他的全部支持使用CCB / ACEI * 卒中与高血压 上海交通大学医学院附属瑞金医院 上海市高血压研究所 王继光 jiguangw@ 卒中在老年高血压患者中的危害 降压治疗对老年高血压患者卒中风险的影响 DHP-CCBs、ACEIs/ARBs、利尿剂以及?受体阻断剂等指南推荐的降压药物与卒中风险 卒中风险与降压药物的血管作用 Incidence of Stroke in the Asian Pacific Region (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). Awareness, treatment and control rates of hypertension in China Prevalence Number of patients Awareness Treated Controlled 1991 (15 y) 11.3％ 94 million 26.6％ 45.5% (12.1％) 23.1% (2.8％) 2002 (?18 y） 18.8％ 160 million 30.2％ 81.8% (24.7％) 25.0% (6.1％) 2002 (?60 y） 49.1