《心血管疾病预防》PPT课件

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1、CVDPreventionCharlieShaeffer,MD,FACCCardiovascularDeathsbyRegionin1990:GlobalBurdonofDiseaseStudy,1990PredictedDuetoCHDDuetoStrokeIncreaseby2002No.(x106)(%)(%)(%)Establishedmarketeconomies3.2532515Formersocialisteconomies2.1503126India2.35220111China2.6

2、305077OtherAsiaandIslands1.33429106Sub-SaharanAfrica0.82647114LatinAmericaandCaribbean0.84432120MiddleEasternCrescent1.34716129CardiovascularDeaths,1990“CardiovasculardeathandincidenceinChinaandIndiamorethandoubledbetween1990and2000.”Yusuf:WCCMay2002Urbani

3、zationChildDeathsandInfectionTobaccoUsePhysicalActivityFatConsumptionStressYusuf:WCCMay2002“Canprevent5/6myocardialinfarctionsbysmokingcessationandbloodpressureandlipidcontrol.”Yusuf:WCCMay2002WorldwideTobaccoMortality1998–4,000,000deaths/year2030–10,

4、000,000deaths/year1/3ofalldeathsHalfofthesedeathswillbeinthe35-65agegroup,withanaveragelossof20-25yearsoflifeNonCigaretteSmokersAllCigaretteSmokers100791146412244135AnginaPectorisMyocardialInfarctionSuddenDeathOBS.EXP.SummaryofNCEPATPIII*Guidelines–LDL-CGo

5、als*NationalCholesterolEducationProgramAdultTreatmentPanelIII.†Therapeuticlifestylechangesinclude:(1)dietarychanges:reducedintakeofsaturatedfatsandcholesterolandenhancedLDLloweringwithplantstanols/sterolsandincreasedsolublefiber;(2)weightreduction;and(3)in

6、creasedphysicalactivity.‡Coronaryheartdisease.§CHDriskequivalentscomprise:diabetes,multipleriskfactorsthatconfera10-yearriskforCHD>20%,andotherclinicalformsofatheroscleroticdisease(peripheralarterialdisease,abdominalaorticaneurysm,andsymptomaticcarotidarte

7、rydisease).װMajorriskfactors(exclusiveofLDL-C)thatmodifyLDL-Cgoalsincludecigarettesmoking,hypertension(BP140/90mmHgoronantihypertensivemedication),lowHDLcholesterol(<40mg/dL),familyhistoryofprematureCHD(CHDinmalefirst-degreerelative<55years;CHDinfemalefir

8、st-degreerelative<65years),age(men45years;women55years).HDLcholesterol60mg/dLcountsasa“negative”riskfactor;itspresenceremoves1riskfactorfromthetotalcount.RiskCategoryNCEPATPIIILDL-CGoal(mg/dL)LDL-CLevelatW