β受体阻滞剂的降压地位文件材料.ppt

   再论?-阻滞剂的降压地位   蒋立新  中国医学科学院 阜外心血管病医院 中国协和医科大学 心血管病研究所  ;报 告 提 纲;肾上腺素能受体亚型的分布与效应;(Partial Agonist activity);?-受体阻滞剂的可能降压机制;?-受体阻滞剂的分类;?-受体阻滞剂的药理学差异;?-阻滞剂的亲脂性和长期心脏保护（一级预防试验）;?-阻滞剂的亲脂性和长期心脏保护（二级预防试验）;?-受体阻滞剂：高血压治疗一线药物;倍他乐克降压的一级预防试验（MAPHY）;MAPHY：总死亡率曲线;;瑞典老年高血压试验（STOP-H）;STOP-H：主要终点和死亡率;Blood Pressure Lowering Treatment Trialists’ CollaborationSecond cycle of overview analyses;Contributing trials;Newer blood pressure lowering agents versus placebo More intensive versus less intensive blood pressure lowering regimens Blood pressure lowering regimens based on different drug classes ;Primary outcomes Stroke Coronary heart disease Heart failure (fatal or hospitalised) Total cardiovascular events (composite of all above) Cardiovascular mortality Total mortality;STROKEComparisons of active treatments and control;STROKEComparisons of different active treatments;CORONARY HEART DISEASEComparisons of active treatments and control;CORONARY HEART DISEASEComparisons of different active treatments;HEART FAILUREComparisons of active treatments and control;HEART FAILUREComparisons of different active treatments;MAJOR CARDIOVASCULAR EVENTSComparisons of active treatments and control;MAJOR CARDIOVASCULAR EVENTS Comparisons of different active treatments;CARDIOVASCULAR DEATHComparisons of active treatments and control;CARDIOVASCULAR DEATHComparisons of different active treatments;TOTAL MORTALITYComparisons of active treatments and control;TOTAL MORTALITYComparisons of different active treatments; Similar net effects on total cardio- vascular events of: Diuretics/beta-blockers ACE inhibitors Calcium antagonists ARBs also effective in reducing total cardiovascular events ; ACE-inhibitor and diuretic/beta-blocker based regimens more effective than calcium antagonists for preventing heart failure Calcium antagonists may be more effective for