降压治疗研究新动态回顾与展望

《降压治疗研究新动态回顾与展望》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、降压治疗研究新动态回顾与展望◆80岁以上高龄高血压(HYVET)◆高血压前期(TROPH,PHARAO)◆心房颤动(ADVANCEposthoc)新动态(一):扩展降压治疗获益人群1.00.90.80.70.60.50.40.30100200300400500600700800900100011001200DaysControlRamiprilSurvivalfunctionPHARAOStudy:PrimaryEndpointDevelopmentofHypertensionHazardratio0.656(0.533-0.8

2、07)LudersS,etal.JHypertens.2008;26:1487-1496*********************************************************************604020090100120130140160170180190200220230240PrehypertensionUncertaintyRange~55–75%ofthegeneralpopulation%ofscreenedpopulationNormotensionPrehypertensionM

3、askedHypertensionSustainedHypertensionMixedpopulationwithWhiteCoatHypertensionandSustainedHypertension(FPs&TPs)MaskedHypertension(officeBP<140/90mmHg)(FNs)ADVANCE-AF研究11140例2型糖尿病，心房颤动占7.6%。perindopril/indapamide降压治疗4.3年，治疗组血压比对照组降低5.3/2.3mmHg。心房颤动患者降压治疗后总死亡率与心血管死亡率分别

4、降低14%与18%，NTT42。EurHeartJ.2009;March12.onlinepublication.TheACTIVESteeringCommittee.AmHeartJ.2006;151:1187-93AtrialfibrillationClopidogrelTrialwithIrbesartanforpreventionofVascularEvents◆脑卒中史(PROGRESS再分析,WASID)◆糖尿病(ADVANCE)新动态(二):心血管高危患者强化血压控制100806040200<120120-1391

5、40-15960100806040200<7070-7980-8990Achievedsystolicbloodpressurelevels(mmHg)Achieveddiastolicbloodpressurelevels(mmHg)Age-andsex-adjustedincidencerateCKD:Ptrend=0.004Non-CKD:Ptrend<0.0001CKD:Ptrend=0.001Non-CKD:Ptrend<0.0001CKDNon-CKDIncidencerate(1000person-years)

6、PROGRESS-CKDSubstudy:SBPandCVDWASIDTrial(Warfarin-AspirinSymtomaticIntracranialDisease)RelationshipBetweenBloodPressureandStrkeRecurrenceinPatientsWithIntracranialArterialStenosisTuranTN,etal.Circulation.2007;115:2969-297510.90.80.70.60.50.40.30.20.10012345Follow-up(

7、yrs)P<0.000110.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)ProbabilityofIschemicStrokeP<0.000110.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)ProbabilityofIschemicStrokeinTerritory10.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)P<0.0065ProbabilityofIschemicStroke

8、inTerritoryP<0.0001ProbabilityofIschemicStroke<=119120-139140-159>=160SBP<=119120-139140-159>=160SBPDBP<=7980-89>=90DBP<=7980-89>=9