课件：高血压的饮食指导.pptVIP

* Epidemiologic research has shown that hypertension usually occurs in conjunction with other CV risk factors. Data from the Framingham study clearly illustrate the co-existence of risk factors in the hypertensive population. In the Framingham population, 20% of hypertension cases occurred in isolation. Most patients (73% in men and 71% in women) had between 1 and 3 risk factors for CV in addition to hypertension. A further 8% and 12% of men and women, respectively, had 4 or more additional risk factors for CVD. * Using data from the Multiple Risk Factor Intervention Trial (MRFIT), Neaton and colleagues examined the interaction between TC levels, SBP, smoking, and CHD death rates. Note the strong, graded relationship between increasing cholesterol levels and CHD death across SBP levels and the similarly strong relationship between small increases in SBP and CHD death across TC levels. When risk factors are analyzed together, patients in both the highest TC and the highest SBP quintiles had an approximately 11-fold greater risk of CHD death than patients who were in both the lowest TC and the lowest SBP quintiles. * Emberson J et al, used estimates of the relative risk reductions from meta-analyses of randomised trials in combination with data from a prospective observational study of CVD (the British Regional Heart Study) to analyse the impact of different risk reduction strategies in primary prevention. The study examined the effects of prevention strategies based on single risk factor assessment or total risk assessment. They concluded that assessment of overall risk leads to more effective intervention than assessment based on single risk factors. Furthermore, multiple interventions have considerably greater benefits than interventions based on targeting single risk factors. Ten percent reductions in long-term mean blood cholesterol and BP could have reduced major CVD by 45%. Jackson R et al, conducted a review of the randomised trials of BP or blood cholesterol