精品课件教案ppt 高血压的流行现状与有效防治.ppt

* * * * * * * * * Findings The overview of placebo-controlled trials of ACE inhibitors (four trials, 12 124 patients mostly with coronary heart disease) revealed reductions in stroke (30% [95% CI 15–43]), coronary heart disease (20% [11–28]), and major cardiovascular events (21% [14–27]). The overview of placebo-controlled trials of calcium antagonists (two trials, 5520 patients mostly with hypertension) showed reductions in stroke (39% [15–56]) and major cardiovascular events (28% [13–41]). In the overview of trials comparing bloodpressure- lowering strategies of different intensity (three trials, 20 408 patients with hypertension), there were reduced risks of stroke (20% [2–35]), coronary heart disease (19% [2–33]), and major cardiovascular events (15% [4–24]) with more intensive therapy. In the overviews comparing different antihypertensive regimens (eight trials, 37 872 patients with hypertension), several differences in cause-specific effects were seen between calciumantagonist- based therapy and other regimens, but each was of borderline significance. Interpretation Strong evidence of benefits of ACE inhibitors and calcium antagonists is provided by the overviews of placebo-controlled trials. There is weaker evidence of differences between treatment regimens of differing intensities and of differences between treatment regimens based on different drug classes. Data from continuing trials of blood-pressure-lowering drugs will substantially increase the evidence available about any real differences that might exist between regimens. * * * 高血压的流行现状与有效防治 武阳丰，教授 中国乔治中心，主任 北京大学临床研究所，常务副所长 为什么要控制高血压? 怎样才能有效控制高血压? 高血压的危害 高血压 靶器官损害：心、脑、肾、眼、外周血管等 发病： 冠心病 脑卒中 肾炎 视网膜病变 间歇跛行 生活质量下降 过早死亡 队列人群不同基线血压水平组观察人数构成比及15年随访期间心脑血管病发病率 (按收缩压分层，调整年龄性别) 全国的高血压患病率 高血压防治的可行性 高血压的检出方法简单、有效、成本低廉。 具有多种、大量、有效、安全、价格低廉的降压药物。 大量的干预试验表明：减轻体重、低盐饮食、增加体力活动等改善生活方式的措施能够有效降低血压水平，可以发挥预防和治疗的双重作用。 大规模临床试验结果表明：有效的降压治疗能够显著地降低心脑血管事件的发生和再发生。 中美两国人群高血压知晓率、治疗率和控制率的比较 美国 NHANES I 1976-80 美国 NHANES II 1988-91 中