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1、ANewLookatCoronaryRiskFactors15thGreatWallInternationalCongressofCardiologyBeijing,ChinaDavidD.Waters,MDOctober18,2004UCSFFernandoBoteroLadywithaGreenParrotLeonardo–16thCenturyBotero–20thCenturyObesityinChina60,000,000obeseadultsinChina7.1%ofthepopulationthisnumberhasdoubledin10yrsHea
2、lthMinistryreport(Oct13,2004)GuanChen,age24,191KgANewLookatCoronaryRiskFactorstheprevalenceoftype2diabetesandobesityareincreasingdramaticallyinmostoftheworldLDL-cholesterolcannowbereadilycontrolledwithstatinsnewriskfactorssuchashs-CRPandCACscorebyEBCTareenteringclinicalusetreatmentspr
3、oventoreduceriskarebeinggreatlyunderutilizedworldwide,aggressivemarketingoftobaccoandtheavailabilityofcheapatherogenicfoodswillleadtoanepidemicofcoronarydiseaseCardiovascularDiseaseHasBecometheLeadingCauseofDeathinChinacross-sectionalsurveyinanationallyrepresentativesampleof15,540Chin
4、eseadultsage35to74,conductedin2000-0124%hadborderlinehightotalcholesterol(200-240mg/dl)and9%hadhighcholesterol(>240mg/dl)17%hadLDL-Cbetween130-159mg/dl,5%hadLDL-Cbetween160-189mg/dl,and2.7%hadanLDL-C>190mg/dl19%hadlowHDL-cholesterol(<40mg/dl)only8.8%ofmenand7.5%ofwomenwereawareoftheir
5、condition;only3.5%weretreatedHeJ,etal,Circulation2004;110:405ExplainingtheIncreaseinCoronaryHeartDiseaseMortalityinBeijingBetween1984and1999validatedmodelusingMONICAandSino-MONICAdatabetween1984and1989,CHDmortalityratesincreasedby50%inmenand27%inwomenaged35-74yearstotalcholesterolincr
6、easedfrom166to206mg/dlsmokingprevalenceincreasedfrom49%to57%inmenanddecreasedinwomenfrom16%to9%prevalenceofdiabetesincreasedfrom3%to9%BMIincreasedfrom23.9to24.9kg/m2CritchleyJ,etal,Circulation2004;110:1236ExplainingtheIncreaseinCoronaryHeartDiseaseMortalityinBeijingBetween1984and1999c
7、hangesinriskfactorstogetherproducedabestestimateof1,822moreCHDdeathsin1999comparedto1984cholesterol77%diabetes19%BMI4%smoking1%improvedtreatmentspreventedorpostponedanestimated642deathstreatmentofMI41%treatmentofhypertension24%secondaryprevention11%heartfailure10%CABGandPTCA2%Critchle
8、yJ,et
