大三下内科学循环hypertension prevention and treatment.pptx

Hypertensionclinical management updateShan Ying, MDDepartment of Cardiology, Huashan HospitalFudan University, Shanghai 200040思考题Antihypertensive management means pharmaceutical therapies?抗高血压治疗就是药物治疗？The benefits of antihypertensive drugs depend on the reduction of BP? 降压幅度是抗高血压治疗临床获益的主要来源？Hypertension EpidemiologySingle largest contributor to death worldwideEvery 20/10 mmHg increase in BP correlates with a doubling of 10-year cardiovascular mortalityDramatically increases risk of stroke, heart attack, heart failure, kidney failureOnly half of all treated hypertensives are controlled to established BP targetsHigh prevalence:Affects 1 in 3 adults1B people worldwide ? 1.6 B by 202535% Treated but Uncontrolled30% Untreated35%Treated ControlledChobanian et al. Hypertension. ?2003;42(6):1206–1252. 72 %NHANES III BP?140/90 mmHg or on therapies8066 %51 %6038 %40Percent hypertensive18 %209 %3 %018-2930-3940-4950-5960-6970-7980+AgePrevelence of HTN in USAJNC-VI. Arch Intern Med. 1997;157:2413-2446.60男性女性5040302010030354045505560657075Prevelence of HTN in China1991 National survey: prevelence = 11.26%2000－2001 InterASIA study：prevelence in age 35-74 = 27.2%，about 13,000,000 patientsPrevelence%ageGu DF, et al. Hypertension. 2002;40:920-927Prevelence of HTN in China2000－2001 InterASIA studyGu DF, et al. Hypertension. 2002;40:920-927中国高血压的现状：各年龄组的患病率都在增加(%)■ 1979■1991 200247%60%77%93%114%Prevalence Rate130%143%173%184%170%97%105%94%Report on Cardiovascular Disease in China(2008-2009)2010年中国成年人（18岁以上）高血压患病情况。收缩压为(130.8±21.3)mm Hg舒张压为(80.4±11.7)mm Hg中国成年人高血压患病率为33.5％，(95％CI：31.6％-35.4％)。 男性：35.1%，95％CI：33.1％-37.1％， 女性：31.8％，95％CI：29.8％～33.9％3.3亿成年人高血压患者BP Control RatesTrends in awareness, treatment, and control of high blood pressure in adults ages 18–74National Health and Nutrition Examination Survey, PercentII1976–80II(Phase 1)1988–91II(Phase 2)1991–941999–2000Awarenesreatmenontroources: Unpublished data for 1999–2000 computed by M. Wolz, Nati