脑卒中降压治疗策略-王拥军PPT.ppt

* 通过APCSC的调研数据可以看到，在澳洲（西方人为主）以及亚洲人群（中国人群为主）的数据显示，SBP越高，致死及非致死出血性卒中发生率越高，但是两个人群之间异致性有显著差异( P值=0.0002)，亚洲人群，随着SBP的增高，致死及非致死出血性卒中发生率更高，远高于澳洲人群（西方人群），这说明SBP对于亚洲人的脑卒中更相关，更敏感。 * 23.01.2008: In 2006 the EUSI decided that a larger group of authors should prepare the next update. In the meantime, a new European Stroke Society, the European Stroke Organization (ESO), was established and took over the task of updating the guidelines. Accordingly, the new recommendations have been prepared by both members of the former EUSI Recommendations Writing Committee and the ESO (see appendix). The members of the Writing Group met in Heidelberg, Germany for 3 days in December 2007 to finalize the new recommendations. The members of the Writing Committee were assigned to six groups covering different topics. Each group was co-chaired by two colleagues, and included up to five further experts. * 23.01.08 PAR * 25.01.08 * 26.01.08 * 23.01.08 PAR * 23.01.08 PAR * 26.01.08: High blood pressure A meta-analysis of seven randomized controlled trials showed that antihypertensive drugs reduced stroke recurrence after stroke or TIA (RR 0.76; 95%CI 0.63-0.92) {Rashid, 2003 #897}. This analysis included the PATS (indapamide, a diuretic), HOPE (ramipril) and PROGRESS (perindopril, with or without indapamide) studies {Group, 1995 #828;Yusuf, 2000 #201;Bosch, 2002 #827;PROGRESS collaborative group, 2001 #141}. The reduction in stroke occurs regardless of BP and type of stroke {PROGRESS collaborative group, 2001 #141}. BP should be lowered and monitored indefinitely after stroke or TIA. The absolute target BP level and reduction are uncertain and should be individualized, but benefit has been associated with an average reduction of about 10/5 mm Hg, and normal BP levels have been defined as 120/80 mm Hg {Chobanian, 2003 #883}. However, blood pressure should not be lowered intensively in patients with suspected haemodynamic stroke. The angiotensin receptor antagonist eprosartan may be more effective tha