冠心病的高压管理.pptVIP

冠心病的高血压管理;高血压与冠心病事件的关系;高血压从 “无需治疗”时代穿越; 罗斯福总统最后一个任期时的文件詳細记载了他的健康 Franklin D. Roosevelt （FDR） was referred to Dr.?Howard Bruenn, a cardiologist at Bethesda Naval Hospital who, on March 27, 1944 found him cyanotic, breathless, with an enlarged left ventricle and a blood pressure of 186/108. Bruenn diagnosed hypertensive heart disease and wanted to give digitalis, but was prohibited by Dr.?Ross McIntire, the presidents personal physician and then surgeon-general of the U.S. Navy. The next day, FDR developed moist rales at the base of the right lung. During a press conference that day, FDR was asked about his physical condition and answered, I got bronchitis. By March 30 crackles were present at the base of both lungs. Bruenn diagnosed congestive heart failure, but it was not until the next day, after FDR was examined by civilian consultants, that digitalis was begun. FDR would continue the digitalis for the rest of his life. By April 3, FDR was better. His color was better, he could lie flat without dyspnea, and the crackles disappeared from both lungs. His blood pressure, however, was 210/110. The nation was stunned when FDR died unexpectedly on April 12, 1945 -- less than six months after being elected to a fourth term in office. The death was unexpected because the presidents personal physician, VADM Ross McIntire, whenever asked, had proclaimed that FDRs health was excellent. 1944年3月27日：血压186/108 1944年4月3日：血压210/110 总统的医生宣称：罗斯福总统健康状况很好！ 1945年4月12日，罗斯福总统死於脑溢血。;治疗的高血压患者;-60;高血压加剧动脉粥样硬化发生;高血压患者的动脉血管;高血压是心血管疾病的独立危险因素;高血压是心血管疾病的独立危险因素;即使年轻高血压患者，AS发生率已高达约50%;阵线前移：从“亡羊补牢”推进到“未雨稠繆”;高血压的治疗目标;高血压患者中危险因素越多，心血管病风险越高;高血压与冠心病事件;收缩压与心血管事件（IDNT研究） ;舒张压与心血管事件（INVEST研究);舒张压与心血管疾病风险的关系;;冠心病合并高血压的管理;冠状动脉的血流特点;冠状动脉的血流特点;冠心病合并高血压治疗—目标降压值;各国最新指南比较;ACS合并高血压管理;ACS合并???血压管理;ACS合并高血压管理;ACS合并高血压管理;加用利尿剂可有利于心力衰竭和血压的控制。 常应用噻嗪类利尿剂控制血压 。 目标血压值130/80 mmHg 低限血压值120/70 mmHg;STEMI患者合并高血压管理; STEMI患者合并高血压管理; STEMI患者合并高血压管理;ACS合并高血压的降压策略;ACS合并高血压的降压策略;ACS合并高血压的降压策略;冠心病合并高血压的管理有诸多问题;