(精选)Case Study教学课件.pptVIP

Case study;Evaluation;Case Study;Positive Risk Factors for CHD ACSM (2006) ;Dyslipidemia Total serum cholesterol 200mg/dL (5.2 mmol/L) or High density lipoprotein (HDL) 40mg/dL (1.03 mmol/L) Low density lipoprotein (LDL) 130mg/dL (3.4mmol/L) Obesity Body Mass Index (BMI) 30 kg/m2 or Waist girth = 102 cm (M); = 88 cm (F) or Waist/hip ration = 0.95 (M); = 0.86 (F) Sedentary Lifestyle Not participating in a regular exercise program Accumulating less than 30 minutes moderate intensity exercise 3-5 days weekly;Initial Risk Stratification;;;Medications;A constellation of cardiovascular risk factors related to hypertension, abdominal obesity, dyslipidemia, and insulin resistance Certain drugs used to treat hypertension may accelerate the appearance of new-onset diabetes. In particular, both β blockers and diuretics have been implicated in this effect. ; ALLHAT In high risk hypertensive patients, the diuretic, chlorthalidone, was 43% more likely than the ACEI, lisinopril, to produce diabetes, but was also 18% more likely than the calcium channel blocker, amlodipine, to produce this adverse effect. HOPE The development of new diabetes was reduced by 34% (p0.001) in the ramipril-treated group. LIFE (Losartan Intervention For Endpoint Reduction in Hypertension) The ARB, losartan, was associated with a 25% relative risk reduction in new-onset diabetes when compared with the β blocker, atenolol VALUE (The Valsartan Antihypertensive Long-term Use Evaluation) Valsartan, was associated with 23% RRR in new-onset diabetes when compared with the calcium channel blocker, amlodipine. ;;Medications;Exercise stress test;Questions;Exercise prescription;ACSM and CDC Recommendation;ACSM Recommendation for Hypertension;Rehabilitation in Coronary Heart Disease ;Recommendations for Patients With Type 2 Diabetes;Recommendations for Patients With Type 2 Diabetes;.;Hypertension;Rehabilitation in Coronary Heart Disease ;