高血压代谢危险因素控制面临的困惑与 及启示_祝之明.pptVIP

高血压代谢危险因素控制面临的困惑与启示 ;Dyslipidemia;;;;;靶器官损害的评价;;干预高血压相关的代谢危险因素能显著降低心脑血管事件吗？;BMI and WC vs fat parameters ;肥胖与心衰 Paradox prognosis: excess body weight have a paradoxical protective role ?;肥胖与AMI ;;BMI不能反映内脏脂肪的实际变化;腹型肥胖的类型与代谢综合征的关系;Proposed mechanisms by which visceral obesity, as the most dangerous form of obesity, could be linked to the athero-thrombotic-inflammatory abnormalities of insulin resistance.;;糖尿病作为冠心病的等危症是有条件的 Diabetes and Coronary Risk Equivalency;理论假说;控制血糖至一定范围显著减少心脑血管事件;ACCORD, ADVANCE, VADT 强化血糖控制无益处 在ACCORD试验结果公布之前一个月，Eur Heart J连续刊登了2篇降糖治疗增加心血管事件的临床研究，编辑部予以评论。 ;DIGAMI 2 trial The impact of glucose lowering treatment on long-term prognosis in patients with type 2 diabetes and myocardial infarction: a report from the DIGAMI 2 trial ;与口服降糖药相比，胰岛素与全因死亡和心血管死亡无关，但可增加非致死心梗或脑卒中(HR:1.95, 95% CI:1.35–2.82; P=0.0004);Euro Heart Survey on Diabetes and the Heart Glucose lowering treatment in patients with coronary artery disease is prognostically important not only in established but also in newly detected diabetes mellitus: a report from the Euro Heart Survey on Diabetes and the Heart ;与口服降糖药相比，对合并糖尿病的冠心病，胰岛素治疗增加1年心血管死亡风险2.23 (95% CI 1.24–4.03; P =0.006)，但对新发糖尿病患者，与未降糖治疗相比，降糖治疗则明显减少其心血管事件;最近的血糖控制试验带来的困惑 ;Jessup M, et al. NEJM, 2003,348:2007-18. Blaschke F, et al. ATVB, 2006,26:28-40 VanGaal LF, et al. Lancet, 2005,365:1389-97;降压药物的选择;降压药物的选择;Effect of Inhibition of the RAS on Development of Type 2 Diabetes Mellitus (Meta-Analysis of Randomized Trials) ;Irbesartan for the treatment of hypertension in patients with themetabolic syndrome: A sub analysis of the Treat to Target postauthorization survey. Prospective observational, two armed studyin 14,200 patients Cardiovascular Diabetology 2007, 6:12;降糖药对心血管事件的影响; 不同降糖药组合对LDL-C和血压影响不同 ;客观评价β-blocker在糖尿病治疗中的作用;Changes in Serum Potassium MediateThiazide-Induced Diabetes;Summary;谢谢！