收缩压、舒张压与心血管风险的关系.ppt

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1、TheRelationshipofSystolicandDiastolicBloodPressuretoCardiovascularDiseaseRisk:ObservationalDataPrevalenceofHypertensionintheUSPercenthypertensive18-29BasedonNHANESIII(phase1and2)Hypertensiondefinedasbloodpressure140/90mmHgortreatment30-3940-4950-5960-6970-7980+Age3%9%18%38%51%6

2、6%72%JNC-VI.ArchInternMed.1997;157:2413-2446.Riskofhypertension(%)Residuallifetimeriskofdevelopinghypertensionamongpeoplewithbloodpressure<140/90mmHgYearsLifetimeRiskofDevelopingHypertensionBeginningatAge65MenWomenVasanRS,etal.JAMA.2002;287:1003-1010.Copyright2002,AmericanMedica

3、lAssociation.MortalityAccordingtoBloodPressureinMenAge50to69SocietyofActuaries.BloodPressureStudy,1939.Ratio(%)ofactualtoexpectedmortalitySystolicbloodpressure(mmHg)Diastolicbloodpressure(mmHg)Age-adjustedannualincidenceofCHDper1000Basedon30yearfollow-upofFraminghamHeartStudys

4、ubjectsfreeofcoronaryheartdisease(CHD)atbaselineSystolicbloodpressure(mmHg)BloodPressureandRiskforCoronaryHeartDiseaseinMenDiastolicbloodpressure(mmHg)Age65-94Age35-64Age65-94Age35-64FraminghamHeartStudy,30-yearFollow-up.NHLBI,1987.RelativeriskofCHDmortalityHeJ,etat.AmHeartJ.19

5、99;138:211-219.Copyright1999,MosbyInc.<112<71RiskofCHDDeathAccordingtoSBPandDBPinMRFIT12345678910Decile112-71-118-76-121-79-125-81-129-84-132-86-137-89-142-92->151>98(lowest10%)(highest10%)SBP(mmHg)DBP(mmHg)Systolicbloodpressure(SBP)Diastolicbloodpressure(DBP)CHD=coron

6、aryheartdiseaseRelativeriskofstrokedeath<112<71RiskofStrokeDeathAccordingtoSBPandDBPinMRFIT12345678910Decile112-71-118-76-121-79-125-81-129-84-132-86-137-89-142-92->151>98(lowest10%)(highest10%)SBP(mmHg)DBP(mmHg)Systolicbloodpressure(SBP)Diastolicbloodpressure(DBP)HeJ,

7、etat.AmHeartJ.1999;138:211-219.Copyright1999,MosbyInc.Age-adjustedannualCVDeventrateper1000WilkingSVetal.JAMA.1988;260:3451-3455.MenWomenIsolatedSystolicHypertensionandCVDRiskinFraminghamISHBP160/<95mmHgBP<140/95mmHg8243332.4182.5CVD=cardiovasculardiseaseISH=isolatedsystolichy

8、pertensionP<0.001fordifferencebetweenbothmenand