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从高血压到心力衰竭挑战与对策-课件，幻灯，PPTPPT
* 071016a_Irbe GLB.IRB.07.10.11 Effects of Antihypertensive Treatment on the Development of HF in Hypertensive Patients The Blood Pressure Lowering Trialists’ Collaboration (n=162,341 patients from 29 studies) estimated effects of different BP lowering regimens on reducing major cardiovascular events, including incidence of HF. The graphic illustrates the effects of different classes of antihypertensive medication regimens on the development of heart failure. For HF that caused death or hospital admission, there was a beneficial effect from ACEI compared with placebo (18%), and ARBs reduced heart failure by 16%. Overall, this study concluded that treatment with any commonly used antihypertensive regimen reduced the risk of total major CV events, and larger reductions in BP produce greater risk reductions.1 Gottdiener noted the following therapeutic regimens in the CHS study. In patients with CHF and normal function, 17.1% were on Beta blocker, 24.7% on ACEI, 58.8% on diuretics, and 30.6% on CCBs. Comparatively, with reduced systolic function and CHF, 6.7% were on beta blockers, 41.7% on ACEI, 78.3% on diuretics, and 30.0% on CCBs.2 Reference: 1. Blood Pressure Lowering Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomized trials. Lancet. 2003;362:1527-1535. 2. Gottdiener JS, McClelland RL. Marshall R. et al. Outcome of congestive heart failure in elderly persons: Influence of left ventricular systolic function. Ann Intern Med. 2002;137:631-639. 从高血压到心力衰竭 挑战与对策 1. McKee et al. N Engl J Med. 1971;285:1441-1446. 2. Levy D. JAMA 1996;275:1557-1562. 高血压: 心力衰竭的主要危险因素 Framingham Heart Study Framingham 随访研究的资料显示，高血压 是心力衰竭发生的主要危险因素。 约90%的心力衰竭患者，在发生心力衰竭前 曾有高血压史。 140/90 140-159/90-99 160/100 BP (mm Hg) Lloyd-Jones et al. Circulation 2002;106: 3068-3072. 3343 men and 4199 women followed for 25 years – no HF at baseline 血压水平与心力衰竭危险 Age Male Fema
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