《高血压防治进》ppt课件.ppt

* The principal finding of VALUE was that, for the primary composite endpoint of cardiac mortality and morbidity, there were no significant differences in these high-risk patients treated with valsartan- or amlodipine-based regimens.1 This was observed despite significant differences in achieved blood pressures. In a recent meta-regression analysis based on 30 hypertension trials with 149,407 patients, differences in achieved SBP were found to largely account for cardiovascular outcomes.2 1. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with valsartan- or amlodipine-based regimens: VALUE, a randomised trial. Lancet. 2004;363. 2. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003;21:1055-1076. * Using the patient cohort established by serial median matching, patient outcomes, including combined cardiac events, were closely similar for the valsartan-based and amlodipine-based regimens.1 Significantly fewer hospitalisations for heart failure occurred in the group given the valsartan-based regimen, supporting the hypothesis that a mechanism other than blood pressure provides benefits in those taking valsartan.1 1. Weber MA et al. Blood pressure dependent and independent effects of antihypertensive treatment on clinical values in the VALUE trial. Lancet. 2004;363:2047-49. *  适应证 强制性禁忌证 可能禁忌证  利尿剂 充血性心力衰竭 痛风 妊娠 收缩期高血压 老年高血压 抗醛固酮 心肌梗死后 肾功能衰竭 高血钾 β-阻滞剂 心绞痛 哮喘 周围血管病 心肌梗死后 慢阻肺病 糖耐量减低 快速心律失常 2-3度房室阻滞 重体力劳动者 充血性心力衰竭 ACEI 充血性心力衰竭 左心室功能不全 双侧肾动脉狭窄