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1、GuidelinesForCardiovascularPreventionDrChan,NgaiYin,MBBS(HK),MRCP(UK),FRCP(Edin),FACC,FAHA,AssociateConsultant,Director,CardiacPacingServices,PrincessMargaretHospital10thSouthChinaInternationalCongressinCardiology,Guangzhou,China,April12,2008CVDandothermajorcauses
2、ofdeath:bothsexes. (UnitedStates:2004).Source:NCHSandNHLBI.CausesofDeath-US57%ofdeathsduetoCVdiseasesSettingtheGoal: AHistoryIn1998,theAHABoardofDirectorsadopteda2010ImpactGoal:By2010,toreducecoronaryheartdisease,strokeandriskby25%.Riskfactorstobemeasuredincluded:
3、TobaccoUsageHighBloodPressureHighCholesterolPhysicalInactivityIn2001,ObesityandDiabeteswereaddedasriskfactors.Ourgoalistoachievea0%growthrateinObesityandDiabetesby2010.CoronaryHeartDiseaseMortality22.8%↓StrokeMortality18.8%↓AHA/ACCGuidelinesforSecondaryPreventionf
4、orPatientsWithCoronaryandOtherAtheroscleroticVascularDisease:2006UpdateLifestylemodificationBloodpressurecontrolLipidmanagementDiabetesmanagementAntithrombotictreatmentRenin-Angiotensin-Aldosteronesystemblockadeβ–blockersInfluenzavaccinationLifestylemodificationSm
5、oking-completecessation,avoidenvironmentalexposurePhysicalactivity-30minutes,7daysperweek(minimum5daysperweek)Weightmanagement-BMI18.5-24.9kg/m2,waistcircumference<40inchesformen,<35inchesforwomenOne-for-allCommunity-BasedPhase2.5CardiacRehabilitationforLow-riskPa
6、tientsPatientswithimplantabledevicesClassIandIIheartfailurepatientsPatientswithcoronaryarterydiseaseaftercompleterevascularizationPatientswithstableanginawithsatisfactorymedicalcontrolPatientswithvalvularheartdiseaseaftersurgicaltreatmentBloodPressureControlGoal:<
7、140/90mmHgor<130/80mmHgifpatienthasdiabetesorchronickidneydiseaseLifestylemodificationAstolerated,addBPmedication,treatinginitiallywithβ–blockersand/orACEI,withadditionofotherdrugssuchasthiazidesNewLipidTarget(1)LaRosaJC,GrundySM,WatersDDetal.Intensivelipidlowerin
8、gwithatorvastatinInpatientswithstablecoronarydisease.NEJM2005;352:1425-3510001ptswithCHDAndLDL<130mg/dlMedianFU4.9yearsMeanLDL77vs101NewLipidTarget(2)La
