冠心病降压治疗决策演示文稿.pptVIP

该幻灯显示了一个心血管事件链1。 高血压等因素能够促进动脉粥样硬化和LVH，并因此增加心脑血管事件的危险性1。如果不治疗，室壁重塑会最终导致充血性心衰、终末期心脏病和死亡。这些情况可以伴有认知功能障碍，疾病进展至痴呆2。 高血压和糖尿病也是导致内皮功能障碍的危险因素。可以引起肾小球损害、微量白蛋白尿和大量蛋白尿，导致进行性肾脏病变和肾功能衰竭的发生3-5。 特异性阻断这些作用的干预措施很可能能够对于延缓这些事件的进展产生明显的获益。 正在进行或已经完成了的大量试验验证了替米沙坦在进行性靶器官损伤多个阶段中的作用，从降低危险因素、改善靶器官损伤的生理学指标至发病率和死亡率。 PROTECTION计划之外，其它调查替米沙坦对心血管事件链的作用的研究包括PRoFESS和ONTARGET。 Dzau V, Braunwald E. Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J 1991;121:1244–1263. Hofman A, et al. Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer’s disease in the Rotterdam study. Lancet 1997;349:151–154. Cooper ME. Pathogenesis, prevention and treatment of diabetic nephropathy. Lancet 1998;352:213–219. Taylor AA. Pathophysiology of hypertension and endothelial dysfunction in patients with diabetes mellitus. Endocrinol Metabol Clin North Am 2001;30:983–997. Erhardt LR. Endothelial dysfunction and cardiovascular disease: the promise of blocking the renin-angiotensin system. Int J Clin Pract 2003;57:211–218. Weber M. The telmisartan Programme of Research tO show Telmisartan End-organ proteCTION (PROTECTION) Programme. J Hypertens 2003;21 (Suppl 6):S37–S46. * Blood Pressure and Risk for Coronary Heart Disease in Men Data from the Framingham Heart Study implicate rising systolic and diastolic blood pressure as risk factors for coronary heart disease. This is true for younger (yellow) and older (blue) age groups and for men and women (data not shown). Reference: The Framingham Study: an epidemiological investigation of cardiovascular disease. Section 34. Some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Heart Study, 30-year follow-up. Bethesda, MD: National Heart, Lung, and Blood Institute, 1987. 现在的模型认为动脉粥样硬化性疾病是一种系统性、进展性疾病。在系列一中，我们从CRP出发，探讨了炎症与动脉粥样硬化的关系。今天我们将把目光对准内皮功能，集中探讨内皮功能与动脉粥样硬化的关系。 * 动脉粥样硬化的病理生理 在心血管疾病中动脉粥样硬