降压的策略和目标课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,降压治疗策略与目标,颜与进展,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,血压、年龄与脑卒中死亡率(100万人群资料分析),256,Aes,50-59,50-59,T,090100110,Usual systolic blood,Usual diastolic blood,Pressure(mmHg),ncct2019,360:1903,血压、年龄与冠心病死亡率(100万人群资料分析),Age at rist,256,Years,70-79,Years,40-49,T,090100110,Usual systolic blood,Usual diastolic blood,Pressure(mmHg),ncct2019,360:1903,收缩压20mmHg差值对心血管危险影响,A:usual systolic blood pressure(2115 mmHg,Age at,Stroke,036(0.320,038(035-0.40),60-69,043(0.41-0.45),70-79,432,0.0(0.48-0.52),IHD,0.49(0450.53),0.50(049-0.52),60-69,10450,0.540.53-0.55),060(0.58-061),0.67(0.64-0.70),Other,043(0.38-0.48),50-59,1377,0.50(0470.54),2549,0.53(0.51-0.56),70-79,3227,0.64(0.61-0.67),80-89,2251,0.70(0.65075),0250.350.50.71.0,Hazard ratio(95%ci)for 20 mmHg,ncct2019,360:1903,Lower usual systolic blood pressur,舒张压10mmHg差值对心血管危险影响,B:usual diastolic blood pressure(275 mmHg),Cause,Age at,Of death,risk(years,Stroke,348,0.35(030-0.40),1243,034(0320.37),0.40(0.38042,70-79,3915,0.48(045051),2340,0.63(0.580.69),40-49,1114,047(0.43-0.51),0.52(0.50-0.55,60-69,9289,0.56(0.540.58),0.70(0.65-074),Other,40-49,0.43(0370.50),vascular,0.48(0.440.52,60-69,2220,0.490.46-0.53),70-79,2853,0.61(0.570.66),80-89,1976,071(0.64079),0.250.35050.71.0,Hazard ratio(95%o ci)for 10 mmHg,ncct2019,360:1903,Lower usual diastolic blood pressure,血压参数预测脑卒中和冠心病死亡率的相对能力,脑卒中,冠心病,SBP,89%,93%,DBP,3%,73%,PP,37%,43%,MAP,100%,97%,Mid BP,100%,100%,Lancet2019,360:1903,ESRD危险性随血压升高而增加,血压分级,患者ESRD数目年龄校正后的校正后的RR,(n=322554)(n=814)每10万人年发生率(95%CD),理想,61089,51,5.3,1.0,正常,81621,6.6,1.200.8-1.7),正常高值,lI,1.9(1.4-2.7),高血压,1级(轻度)85684275,21.0,2级(中度)23459,158,43.6,6.0(43-8.4),3级(重度)5464,11.2(7.7-16.2),4级(极重度)1429,2.1(142-34.3),Klag M,Whelton PK,Randal BL et al,New Eng J Med.2019;334:14-18,血压水平的分类和定义(JNC7),分类,收缩压mmHg)舒张压mmHg),正常血压,120,80,高血压前期120-139或80-89,高血压1级140-159或90-99,高血压2级,160,或100,血压水平的分类和定义(ESHESC2019),分类,收缩压mmHg)舒张压mmHg),理想血压,正常血压,120-129,正常高值,130-139,8589,级高血压(轻度,2级高血压(中度),160-179,100-109,3级高血压(重度,160,110,单纯收缩期高血压,140,90,