多重心血管风险患者管理资料讲解.ppt

New Frontiers in CVD Risk Management:Optimizing Outcomes in Patients with Multiple Cardiovascular Risks;Obesity;Cardiovascular risk factors, adults 55–64 years;Jackson R et al. Lancet. 2005;365:434-41.; ;Decline in smoking vs rise in obesity: A trade-off?;Development and progression of CVD;Traditional CVD risk factors;Selected emerging biomarkers ;LDL infiltration triggers inflammatory response;Role of ox-LDL in macrophage recruitment;Hypertension increases atherogenic lipoprotein content of arterial vessel walls;AT1 and LOX-1 receptor cross-talk promotes adhesion molecule expression ;Lipoprotein-associated phospholipase A2 (Lp-PLA2);Studies demonstrating association of Lp-PLA2 with incident CHD;Hill JM et al. N Engl J Med. 2003;348:593-600.;Werner N et al. N Engl J Med. 2005;353:999-1007.;Arterial stiffness: Cause and consequence of atherosclerosis;Correlation between number of risk factors and arterial distensibility;Herrington DM et al. Circulation. 2004;110:432-7.;;High-dose statin treatment reduces Ox-LDL markers;Statin treatment reduces Lp-PLA2 ;Statins increase circulating EPCs;Intensive lipid lowering improves arterial compliance;Comparative effects of statin and ezetimibe on EPCs and endogenous antioxidant system;Pre-treated with statin before occlusion;Pleiotropic effects of BP-lowering agents;Mason RP et al. Am J Cardiol. 2005;96(suppl):11F-23F.;Fogari R et al. Am J Hypertens. 2004;17:823-7.;Beneficial effect of statin + ACEI on endothelial function;Approaches to CVD prevention;Lifestyle changes reduce need for drug therapy;;Exercise reduces CV and all-cause mortality;Parikh P et al. J Am Coll Cardiol. 2005;45:1379-87. Trichopoulou A et al. BMJ. 2005;330:991-7. Knoops KTB et al. JAMA. 2004;292:1433-9.;Potential cardioprotective mechanisms of dietary components;Non-pharmacologic interventions and BP reduction;Benefit of multifactorial interventions;Key findings from recent lipid-lowering trials;PROVE IT-TIMI 22: Assessment of intensive lipi