血压波动阵发性高血压与卒中风险课件.pptVIP

Peter M Rothwell 神经病学 教授 牛津大学卒中预防研究中心主任 北京天坛国际脑血管病会议 2010.6;Limitations of the usual blood-pressure hypothesis and importanceof variability, instability, and episodichypertension Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis Effects of beta blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke ;血压真值理论存在的问题 临床使用范围 卒中流行病学 统计学基础 试验证据 血压波动对卒中风险的预测价值 不同种类药物对血压波动的影响;年龄 血管病 昼夜变异 诱发因素 个人因素 性别 种族 肾衰，糖尿病 血管性痴呆;统计学指标 SD CV VIM ASV RSD Peak size Trough size;Lancet 2010；375：895-905;UT-TIA研究中收缩压??大值和最小值与继发卒中的相应危险度;Mean(SD) SBP(mmHg) at baseline and during follow-up stratified by randomised treatment in the ALLHAT trial;Lancet Neurol 2010; 9: 469-80;Effect of treatment allocation on visit-to-visit variability in SBP in ASCOT;Lancet Neurol 2010; 9: 469-80;Average within-individual daytime SD SBP on repeated ABPM in ASCOT-BPLA;Group SD SBP in the MRC Trial in elderly hypertensive patients;MRC研究中老年高血压患者的各治疗组的收缩压标准差;所有关于降压药物的随机对照临床试验的系统回顾;Random effects meta-analysis of cardiovascular outcomes for each drug class versus all other classes combined;Pooled estimates of variance ratio between drug classes in parallel group trials;牛津血管研究对TIA或小卒中病人进行随访，每天随访进行3次家庭血液测量（取10分钟内3次测量的平均值），揭示了CCB对个体血压波动的影响。