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1、HypertensionclinicalmanagementupdateLiYong,MDProfessorofMedicineDepartmentofCardiology,HuashanHospitalFudanUniversity,Shanghai200040思考题Antihypertensivemanagementmeanspharmaceuticaltherapies?抗高血压治疗就是药物治疗？ThebenefitsofantihypertensivedrugsdependonthereductionofBP?降压幅度是抗高
2、血压治疗临床获益的主要来源？Sources:WHOWorldHealthReport2000,CVDinfobase18,000,000fromhigh-incomecountries42,000,000fromlow-incomecountriesImportanceofHypertensionandCVD60,000,000HTNpatientshavetherisktodeveloptoMI,stroke,andheartfailureWorldHeartFederationEpidemiologyofHypertension
3、PrevelenceofHTNinUSAJNC-VI.ArchInternMed.1997;157:2413-2446.NHANESIIIBP140/90mmHgorontherapiesPercenthypertensive18-2930-3940-4950-5960-6970-7980+Age3%9%18%38%51%66%72%020406080PrevelenceofHTNinChinaGuDF,etal.Hypertension.2002;40:920-9270102030405060303540455055606570
4、75男性女性1991Nationalsurvey:prevelence=11.26%2000－2001InterASIAstudy：prevelenceinage35-74=27.2%，about13,000,000patientsPrevelence%age2000－2001InterASIAstudyGuDF,etal.Hypertension.2002;40:920-927PrevelenceofHTNinChinaBPControlRatesTrendsinawareness,treatment,andcontrolofhi
5、gh bloodpressureinadultsages18–74NationalHealthandNutritionExaminationSurvey,PercentII1976–80II(Phase1)1988–91II(Phase2)1991–941999–2000Awareness51736870Treatment31555459Control10292734Sources:Unpublisheddatafor1999–2000computedbyM.Wolz,NationalHeart,Lung,andBloodInsti
6、tute;JNC6.中国高血压治疗现状知晓率治疗率控制率200230.2%24.7%6.1%199126.6%12.2%2.9%2004年发布的《中国居民营养与健康现状》调查结果显示：ChinJhypervol12No.6487-489ChinJhypervol12No.6487-489患病率患病人数高血压18.8%>1.6亿糖尿病2.6%>2000万糖耐量异常1.90%2000万超重22.80%2亿肥胖7.10%>6000万高TC(>5.72mmol/L)2.90%1.6亿人次高TG(>1.7mmol/L)11.90%低HDL(<
7、0.91mmol/L)7.40%中国高血压治疗现状Riskofhypertension(%)Residuallifetimeriskofdevelopinghypertensionamongpeoplewithbloodpressure<140/90mmHgYearsLifetimeRiskofDevelopingHypertensionBeginningatAge55MenWomenVasanRS,etal.JAMA.2002;287:1003-1010.CVMortalityRiskDoubleswith Each20/10mm
8、HgBPIncrement**Individualsaged40-69years,startingatBP115/75mmHg.CV,cardiovascular;SBP,systolicbloodpressure;DBP,diast
