高血压防治指南和合理用药及治疗方案.pptVIP

* * * * In the MRFIT study, systolic BP was more strongly related to the risk of stroke than was DBP. For example, in the highest decile (≥151 mm Hg/≥98 mm Hg), the relative risk of stroke was 8.2 for systolic BP and 4.4 for DBP.1 1. He J, Whelton PK. Elevated systolic blood pressure as a risk factor for cardiovascular and renal disease. J Hypertens. 1999;17(suppl 2):S7-S13. * * Elevated systolic BP correlates with an increase in the adjusted relative risk of end-stage renal disease (ESRD). For example, those in the highest systolic BP quintile (140 mm Hg) had 5 times the relative risk of developing ESRD compared with those in the lowest systolic BP quintile (117 mm Hg).1 1. He J, Whelton PK. Elevated systolic blood pressure as a risk factor for cardiovascular and renal disease. J Hypertens. 1999;17(suppl 2):S7-S13. * * This shows the overall benefit of treatment. There are large reductions in deaths from stroke, CHD and vascular disease, but not increase in death from other causes. * * 各位老师一定非常清楚，有效的降压才是减少心脑血管事件的根本，我们在INSIGHT研究中也得到了同样的结论，拜新同不仅有效降压，而且使高血压患者心脑血管事件发生率降低了50%！ 注：按照Framingham试验数据进行预计，如果入选拜新同组的患者不进行降压治疗，心脑血管事件的发生率将为34例/1000病例年。而在INSIGHT试验中，经拜新同治疗的患者心脑血管事件的发生率仅为17例/1000病例年，比预计的34例/1000病例年降低50%。以上表明，拜新同治疗伴有心血管危险因素的高血压可使心脑血管事件的发生减少50%。 * * Analyses for major CV events, CV mortality, and total mortality did not show significant differences among ?-blockers/diuretics, CAs, or ACE inhibitors.29 29. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527-1535. SLIDE * * * When pooled, the outcomes data indicate that patients who were controlled, regardless of treatment regimen, had significantly better outcomes than those whose blood pressure was not controlled at 6 months.1 Early blood pressure control was a powerful determinant of almost all endpoints (except myocardial inf