高血压防治指南2009.ppt

* Ref 1: P.205S Col.1 Par.1 S.3-5; P.209S Col.1 Par.2 S.2-6; P.209S Col.2 Par.2 S.last; P.210S Col.2 Par.3 S.1 Ref 2: P.1632 Col.1 Par.5 S.2-6; P.1634 Col.1 Par.2 S.1-2,7-8 Ref 3: P.175 Col.1 Par.1 S.2 Ref 4: P.188 Col.1 Par.2 S.1 Slide 2: Consequences of Hypertension Hypertension can lead to a number of serious health problems. A person with hypertension is at increased risk for renal failure at an early age, myocardial infarction (MI), disabling or fatal left ventricular failure, sudden cardiac death, cerebral hemorrhage or infarction, and dementia.2-4 [Ref 2: P.1634 Col.1 Par.2 S.1-2; Ref 3: P.175 Col.1 Par.1 S.2; Ref 4: P.188 Col.1 Par.2 S.1] References: 1. Weir MR, Dzau VJ. The renin-angiotensin-aldosterone system: A specific target for hypertension management. Am J Hypertens 1999;12:205S-213S. 2. Arterial Hypertension. In: Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, New Jersey: Merck Research Laboratories; 1999:1629-1648. 3. Francis CK. Pathogenesis of coronary artery disease. In: Izzo JL Jr, Black HR, eds. Hypertension Primer: The Essentials of High Blood Pressure. 2nd ed. Dallas, Texas: American Heart Association; 1999:175-176. 4. Hershey LA. Pathogenesis of vascular disease and mixed dementia. In: Izzo JL Jr, Black HR, eds. Hypertension Primer: The Essentials of High Blood Pressure. 2nd ed. Dallas, Texas: American Heart Association; 1999:188-189. * * 高血压的治疗 最大限度地降低心血管发病和死亡的总危险 治疗高血压的主要目的 高血压的治疗对策 25 干预患者检查出来的所有可逆性心血管病的危险因素 并适当处理病人同时存在的各种临床情况 降压的益处 收缩压分布 干预前 干预后 血压 降低 收缩压降低 mmHg 2 3 5 死亡率降低（％） 脑卒中 冠心病 总死亡率 – 6 – 4 – 3 – 8 – 5 – 4 –14 – 9 – 7 15 N=52,348, 随访5年 SBP 差 10-12 mmHg DBP 差 5-6 mmHg T=治疗 C=对照 中风 39%(SE 4) 0.001 CHD 16% (SE 4) 0.001 血管死亡 21% (SE 4) 0.001 所有其它死亡 2% (SE 5) 0.5 % reduction in odds: 2P 值: MacMahon, Rodgers, J Hypertens 1994;12 (Suppl 10):S5; Rodgers, Macmahon. BMJ 1996;313:147. 抗高血压治疗的随机试验概述 827 T 1041 C 79