心血管疾病预防.pptxVIP

CVDPreventionCharlieShaeffer,MD,FACC

CardiovascularDeathsbyRegionin1990:

GlobalBurdonofDiseaseStudy,1990 Predicted

DuetoCHD DuetoStroke Increaseby2002

No.(x106) (%) (%) (%)Establishedmarketeconomies 3.2 53 25 15Formersocialisteconomies 2.1 50 31 26India 2.3 52 20 111China 2.6 30 50 77OtherAsiaandIslands 1.3 34 29 106Sub-SaharanAfrica 0.8 26 47 114LatinAmericaandCaribbean 0.8 44 32 120MiddleEasternCrescent 1.3 47 16 129CardiovascularDeaths,1990

“CardiovasculardeathandincidenceinChinaandIndiamorethandoubledbetween1990and2000.”Yusuf:WCCMay2002

Urbanization?ChildDeathsandInfection?TobaccoUse?PhysicalActivity?FatConsumption?StressYusuf:WCCMay2002

“Canprevent5/6myocardialinfarctionsbysmokingcessationandbloodpressureandlipidcontrol.”Yusuf:WCCMay2002

WorldwideTobaccoMortality1998–4,000,000deaths/year2030–10,000,000deaths/year1/3ofalldeathsHalfofthesedeathswillbeinthe35-65agegroup,withanaveragelossof20-25yearsoflife

NonCigaretteSmokersAllCigaretteSmokers100791146412244135AnginaPectorisMyocardialInfarctionSuddenDeathOBS.EXP.

SummaryofNCEPATPIII*Guidelines–LDL-CGoals *NationalCholesterolEducationProgramAdultTreatmentPanelIII. ?Therapeuticlifestylechangesinclude:(1)dietarychanges:reducedintakeofsaturatedfatsandcholesterolandenhancedLDLloweringwithplantstanols/sterolsandincreasedsolublefiber;(2)weightreduction;and(3)increasedphysicalactivity. ?Coronaryheartdisease. §CHDriskequivalentscomprise:diabetes,multipleriskfactorsthatconfera10-yearriskforCHD20%,andotherclinicalformsofatheroscleroticdisease(peripheralarterialdisease,abdominalaorticaneurysm,andsymptomaticcarotidarterydisease). ?Majorriskfactors(exclusiveofLDL-C)thatmodifyLDL-Cgoalsincludecigarettesmoking,hypertension(BP?140/90mmHgoronantihypertensivemedication),lowHDLcholesterol(40mg/dL