抗高血压药物引起的糖尿病不容忽视英文.pptxVIP

抗高血压药物引起的糖尿病不容忽视英文第1页/共28页 Prevalence of diabetes among Chinese adults aged 35–64 years in the 1994 Chinese National Survey (10) and 2000–2001 InterASIA StudyGu et al Diabetologia. 2003;46:1190.第2页/共28页 Percent of deathsGeiss LS, et al. In: Diabetes in America. National Institutes of Health;1995.65% of Mortality in people with Diabetes is CVD Ischemic heart diseaseOther heart diseaseDiabetesMalignant neoplasmsCerebrovascular diseasePneumonia/influenzaAll other第3页/共28页 CV mortality rate per10,000 person-yearsSystolic BP and CV Death in MRFITNondiabetic (n=342,815)Diabetic (n=5,163)120120-139Systolic BP (mmHg)140-159160-179180-199?200Stamler J, et al. Diabetes Care. 1993;16:434-444.BP= blood pressure CV=cardiovascular MRFIT=Multiple Risk Factor Intervention Trial第4页/共28页 Annual Incidence of Diabetes in Hypertensive PatientsSHEP untreated controls = 2.7%SHEP treated = 3.9%Lancet. 2006, 368;1673-1679, Am J Cardiol. 2005;95:29,Hypertension.2007;50:467, JAMA 2002;288:2981-2997 第5页/共28页 NHANES 18 year Follow-upNOD in US Women by Baseline BPConen, D. et al. Eur Heart J 2007 28:2937-2943120120-129130-139140mmHg第6页/共28页 .Conen, D. et al. Eur Heart J 2007 28:2937-2943Age-adjusted incidence rates (A) and HRs (B) of NOD according to blood pressure category, stratified by baseline body mass index第7页/共28页 THE ISSUESCONSEQUENCES OF NODCVD AND non-CVDHOW DO ANTIHYPERTENSIVE DRUGS EFFECT INCIDENCE OF NOD AND CVD ONSEQUENCES?HOW SHOULD NOD EFFECT MANAGEMENT FOR CVD PROTECTION?第8页/共28页 Non-CVD Consequences of NODImpaired BP controlBehavioral and PsychologicalMicrovascular consequences (?)? Medical care demandsTreatment changes第9页/共28页 CVD ConsequencesShort and Long termAntihypertensive Drug Related第10页/共28页 .Whelton, P. K. et al. Arch Intern Med 2005;165:1401-1409.ALLHATIncidence of Coronary heart disease by treatment group according to baseline diabetes mellitus, impaired fasting glucose level, or normoglycemia第11页/共28页 Barzilay, J. I. et al ALLHAT. Arch Intern Med 2006;166:2191-2