心血管预防指南英文.pptxVIP

心血管预防指南英文第1页/共28页 Guidelines For Cardiovascular Prevention第2页/共28页 CVD and other major causes of death: both sexes.(United States: 2004). Source: NCHS and NHLBI. Causes of Death-US57% of deaths due to CV diseases第3页/共28页 Setting the Goal:A HistoryIn 1998, the AHA Board of Directors adopted a 2010 Impact Goal:By 2010, to reduce coronary heart disease, stroke and risk by 25%.Risk factors to be measured included:Tobacco UsageHigh Blood PressureHigh CholesterolPhysical InactivityIn 2001, Obesity and Diabetes were added as risk factors.Our goal is to achieve a 0% growth rate in Obesity and Diabetes by 2010.第4页/共28页 Coronary Heart Disease Mortality22.8%↓第5页/共28页 Stroke Mortality18.8%↓第6页/共28页 AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 UpdateLifestyle modificationBlood pressure controlLipid managementDiabetes managementAntithrombotic treatmentRenin-Angiotensin-Aldosterone system blockadeβ –blockersInfluenza vaccination第7页/共28页 Lifestyle modificationSmoking -complete cessation, avoid environmental exposurePhysical activity -30 minutes, 7 days per week (minimum 5 days per week)Weight management -BMI 18.5-24.9kg/m2, waist circumference 40 inches for men, 35 inches for women第8页/共28页 One-for-all Community-Based Phase 2.5 Cardiac Rehabilitation for Low-risk PatientsPatients with implantable devicesClass I and II heart failure patientsPatients with coronary artery disease after complete revascularizationPatients with stable angina with satisfactory medical controlPatients with valvular heart disease after surgical treatment第9页/共28页 第10页/共28页 第11页/共28页 Blood Pressure ControlGoal: 140/90mmHg or 130/80mmHg if patient has diabetes or chronic kidney diseaseLifestyle modificationAs tolerated, add BP medication, treating initially with β –blockers and/or ACEI, with addition of other drugs such as thiazides第12页/共28页 New Lipid Target (1)LaRosa JC, Grundy SM, Waters DD et al. Intensive lipid lowering with ator