降压治疗的策略和目标PPT课件.ppt

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1、降压治疗策略与目标回顾与进展降压治疗策略研究的重点血压水平与心血管危险降压治疗与心血管危险控制治疗益处及来源(why)治疗对象(who)治疗目标水平(what)治疗方案(which)Lancet2002,360:1903血压、年龄与脑卒中死亡率(100万人群资料分析)Strokemortality(floatingabsoluteriskand95%CI)2561286432168421120140160180UsualsysytolicbloodPressure(mmHg)UsualdiastolicbloodPressure(mmHg)256128643

2、2168421708010011090Strokemortality(floatingabsoluteriskand95%CI)A:SystolicbloodpressureB:DiastolicbloodpressureAgeatrist:80-89Years70-79Yaes60-69years50-59YearsAgeatrist:80-89Years70-79Yaes60-69years50-59YearsIHDmortality(floatingabsoluteriskand95%CI)2561286432168421120140160180Usu

3、alsysytolicbloodPressure(mmHg)UsualdiastolicbloodPressure(mmHg)2561286432168421708010011090IHDmortality(floatingabsoluteriskand95%CI)A:SystolicbloodpressureB:DiastolicbloodpressureAgeatrist:80-89Years70-79Yaes60-69years50-59Years40-49yearsAgeatrist:80-89Years70-79Yaes60-69years50-5

4、9Years40-49yearsLancet2002,360:1903血压、年龄与冠心病死亡率(100万人群资料分析)CauseAgeatNumberofOfdeathrisk(years)deathsStroke40-494140.36(0.32-0.40)50-5913720.38(0.35-0.40)60-6929390.43(0.41-0.45)70-7943270.50(0.48-0.52)80-8926360.67(0.63-0.71)IHD40-4913220.49(0.45-0.53)50-5955940.50(0.49-0.52)60-69

5、104500.54(0.53-0.55)70-79108520.60(0.58-0.61)80-8956490.67(0.64-0.70)Other40-493860.43(0.38-0.48)vascular50-5913770.50(0.47-0.54)60-6925490.53(0.51-0.56)70-7932270.64(0.61-0.67)80-8922510.70(0.65-0.75)0.250.350.50.71.0A:usualsystolicbloodpressure(115mmHg)Hazardratio(95%CI)for20mmH

6、gLowerusualsystolicbloodpressureLancet2002,360:1903收缩压20mmHg差值对心血管危险影响CauseAgeatNumberofOfdeathrisk(years)deathsStroke40-493480.35(0.30-0.40)50-5912430.34(0.32-0.37)60-6926460.40(0.38-0.42)70-7939150.48(0.45-0.51)80-8923400.63(0.58-0.69)IHD40-4911140.47(0.43-0.51)50-5949450.52(0.50

7、-0.55)60-6992890.56(0.54-0.58)70-7997270.62(0.60-0.64)80-8950680.70(0.65-0.74)Other40-493160.43(0.37-0.50)vascular50-5911400.48(0.44-0.52)60-6922200.49(0.46-0.53)70-7928530.61(0.57-0.66)80-8919760.71(0.64-0.79)0.250.350.50.71.0B:usualdiastolicbloodpressure(75mmHg)Hazardratio(95%CI

8、)for10mmHgLowerusualdiasto