降压治疗策略与目标的回顾及进展培训讲座教学PPT课件.ppt

降压治疗策略与目标回顾与进展;降压治疗策略研究的重点;Lancet 2002,360:1903;IHD mortality (floating absolute risk and 95%CI);Cause Age at Number of Of death risk(years) deaths Stroke 40-49 414 0.36 (0.32-0.40) 50-59 1372 0.38 (0.35-0.40) 60-69 2939 0.43 (0.41-0.45) 70-79 4327 0.50 (0.48-0.52) 80-89 2636 0.67 (0.63-0.71) IHD 40-49 1322 0.49 (0.45-0.53) 50-59 5594 0.50 (0.49-0.52) 60-69 10450 0.54 (0.53-0.55) 70-79 10852 0.60 (0.58-0.61) 80-89 5649 0.67 (0.64-0.70) Other 40-49 386 0.43 (0.38-0.48) vascular 50-59 1377 0.50 (0.47-0.54) 60-69 2549 0.53 (0.51-0.56) 70-79 3227 0.64 (0.61-0.67) 80-89 2251 0.70 (0.65-0.75) ;Cause Age at Number of Of death risk(years) deaths Stroke 40-49 348 0.35 (0.30-0.40) 50-59 1243 0.34 (0.32-0.37) 60-69 2646 0.40 (0.38-0.42) 70-79 3915 0.48 (0.45-0.51) 80-89 2340 0.63 (0.58-0.69) IHD 40-49 1114 0.47 (0.43-0.51) 50-59 4945 0.52 (0.50-0.55) 60-69 9289 0.56 (0.54-0.58) 70-79 9727 0.62 (0.60-0.64) 80-89 5068 0.70 (0.65-0.74) Other 40-49 316 0.43 (0.37-0.50) vascular 50-59 1140 0.48 (0.44-0.52) 60-69 2220 0.49 (0.46-0.53) 70-79 2853 0.61 (0.57-0.66) 80-89 1976 0.71 (0.64-0.79) ;血压参数预测脑卒中和冠心病死亡率的相对能力;ESRD危险性随血压升高而增加;血压水平的分类和定义(JNC-7);血压水平的分类和定义(ESH/ESC 2003);;;降压治疗临床试验荟萃分析结果;;;Trial;Eur Heart J 1999:1(suppl):p3;PROGRESS: 预防脑卒中再发;降压治疗的益处;Trials Number of Odds ratios Diferece vents/paitients (95% Cls) (SD) Old New MIDAS/NICS/VHAS 15/1358 15/1353 STOP2/CCBs 369/2213 362/2196 NORDIL 228/5471 153/3157 INSIGHT 152/3164 153/3157 ALLHAT/Aml 2203/15255 1256/9048 ELSA 17/1157 13/1177 CCBs without CONVINCE 2984/28618 2030/22341 -3.1% (3.2) 2P=0.31 Heterogeneity P=0.95 CONVINCE 319/8297 337/8179 All CCBs 3303/36915 2367/30520 -2.3% (2.9) 2P=0.42 Heterogeneity P=0.95 UKPDS 59/358 75/400 STOP2/ACEIs 369/2213 380/2205 CAPPP 190/5493 184/5492 ALLHA/Lis 2203/15255 1314/3044 ANBP2 210/3039 195/3044 HYVET/AD 30/426 27/431 All ACEIs 3061/26784 2175/20626 -0.4% (3.1) 2P=0.89 Heterogeneity P=0.90 LIFE 431/4588 383/4605 SCOPE 266/2460