ARB在心衰中治疗地位及临床应用.pptVIP

* Framingham Heart Study investigators determined the lifetime risk (up to age 94 years) for developing overt HF at selected index ages in a 25-year follow-up of a population-based sample of men and women who were free of HF at baseline.1 At age 40 years, the lifetime risk for HF was 21% for men and 20% for women. Remaining lifetime risk did not change with advancing index age because of the rapidly increasing HF incidence rate: at age 80 years, the lifetime risk was 20% for men and 19% for women. Overall, when established clinical criteria are used to define overt HF, the lifetime risk is 20% (or 1 in 5) for both men and women. 1. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D’Agostino RB, Kannel WB, et al. Lifetime risk for developing congestive heart failure: The Framingham Heart Study. Circulation. 2002;106:3068-3072. * 1. Levy D, Larson MG, Vasan RS, Kannel WB, Ho KKL. The progression from hypertension to congestive heart failure. JAMA. 1996;275:1557-1562. Hypertension is the most common risk factor for HF. In a population-based sample followed for up to 20 years, investigators for the Framingham Heart Study determined that hypertension antedated the development of HF in 91% of cases.1 Hypertension carried the greatest population-attributable risk for development of HF of all risk factors: 39% in men and 59% in women. The risk for developing HF is ~2? greater in hypertensive men and ~3? greater in hypertensive women compared with normotensive subjects. Overall, hypertension is present in ~60% of men and women with HF. In addition, the risk of HF is ~6? greater in men and women who have had a myocardial infarction (MI). Angina, valvular heart disease, left ventricular (LV) hypertrophy, and diabetes also were predictive of increased risk for HF in both sexes. * Muntwyler J, Abetel G, Gruner C, et al. One-year mortality among unselected outpatients with heart failure. Eur Heart J. 2002; 23:1861-1866. Ahmed A., Aronow W., Fleg J. Higher New Yor