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1、降壓治療研究新動態(tài)回顧與展望◆80歲以上高齡高血壓(HYVET)◆高血壓前期(TROPH,PHARAO)◆心房顫動(ADVANCEposthoc)新動態(tài)(一):擴展降壓治療獲益人群1.00.90.80.70.60.50.40.30100200300400500600700800900100011001200DaysControlRamiprilSurvivalfunctionPHARAOStudy:PrimaryEndpointDevelopmentofHypertensionHazardratio0.656(0.533-0.8
2、07)LudersS,etal.JHypertens.2008;26:1487-1496*********************************************************************604020090100120130140160170180190200220230240PrehypertensionUncertaintyRange~55–75%ofthegeneralpopulation%ofscreenedpopulationNormotensionPrehypertensionM
3、askedHypertensionSustainedHypertensionMixedpopulationwithWhiteCoatHypertensionandSustainedHypertension(FPs&TPs)MaskedHypertension(officeBP<140/90mmHg)(FNs)ADVANCE-AF研究11140例2型糖尿病，心房顫動占7.6%。perindopril/indapamide降壓治療4.3年，治療組血壓比對照組降低5.3/2.3mmHg。心房顫動患者降壓治療后總死亡率與心血管死亡率分別
4、降低14%與18%，NTT42。EurHeartJ.2009;March12.onlinepublication.TheACTIVESteeringCommittee.AmHeartJ.2006;151:1187-93AtrialfibrillationClopidogrelTrialwithIrbesartanforpreventionofVascularEvents◆腦卒中史(PROGRESS再分析,WASID)◆糖尿病(ADVANCE)新動態(tài)(二):心血管高危患者強化血壓控制100806040200<120120-1391
5、40-159?60100806040200<7070-7980-89?90Achievedsystolicbloodpressurelevels(mmHg)Achieveddiastolicbloodpressurelevels(mmHg)Age-andsex-adjustedincidencerateCKD:Ptrend=0.004Non-CKD:Ptrend<0.0001CKD:Ptrend=0.001Non-CKD:Ptrend<0.0001CKDNon-CKDIncidencerate(1000person-years)
6、PROGRESS-CKDSubstudy:SBPandCVDWASIDTrial(Warfarin-AspirinSymtomaticIntracranialDisease)RelationshipBetweenBloodPressureandStrkeRecurrenceinPatientsWithIntracranialArterialStenosisTuranTN,etal.Circulation.2007;115:2969-297510.90.80.70.60.50.40.30.20.10012345Follow-up(
7、yrs)P<0.000110.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)ProbabilityofIschemicStrokeP<0.000110.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)ProbabilityofIschemicStrokeinTerritory10.90.80.70.60.50.40.30.20.10012345Follow-up(yrs)P<0.0065ProbabilityofIschemicStroke
8、inTerritoryP<0.0001ProbabilityofIschemicStroke<=119120-139140-159>=160SBP<=119120-139140-159>=160SBPDBP<=7980-89>=90DBP<=7980-89>=9
