心血管预防指南英文.ppt
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Coronary Heart Disease Mortality
2.5
2
22.8%↓
Deaths per 100K
1.5
1
0.5
0 Baseline
2002
2003
2004
Year Data Reported Baseline=NVSS 1999
2005
Coronary Heart Disease
Nห้องสมุดไป่ตู้w Lipid Target (1)
medical control • Patients with valvular heart disease after
surgical treatment
Blood Pressure Control
• Goal: <140/90mmHg or <130/80mmHg
if patient has diabetes or chronic kidney disease • Lifestyle modification • As tolerated, add BP medication, treating initially with β –blockers and/or ACEI, with addition of other drugs such as thiazides
Guidelines For Cardiovascular Prevention
Dr Chan, Ngai Yin, MBBS(HK), MRCP(UK), FRCP(Edin), FACC, FAHA, Associate Consultant, Director, Cardiac Pacing Services, Princess Margaret Hospital
10th South China International Congress in Cardiology, Guangzhou, China, April 12, 2008
Causes of Death-US
900,000 800,000 700,000 600,000
Deaths 500,000
• Weight management -BMI 18.5-24.9kg/m2, waist circumference <40 inches for
men, <35 inches for women
One-for-all Community-Based Phase 2.5 Cardiac Rehabilitation for Low-risk Patients
•Risk factors to be measured included: •Tobacco Usage
•High Blood Pressure •High Cholesterol •Physical Inactivity
•In 2001, Obesity and Diabetes were added as risk factors. •Our goal is to achieve a 0% growth rate in •Obesity and Diabetes by 2010.
Setting the Goal: A History
•In 1998, the AHA Board of Directors adopted a 2010 Impact Goal:
•By 2010, to reduce coronary heart disease, stroke and risk by 25%.
2010 GOAL
2006
2007
Stroke Mortality
Deaths per 100K
0.7 0.6 0.5 0.4 0.3 0.2 0.1
0 Baseline
2002
18.8%↓
Stroke 2010 GOAL
2003
2004
Year Data Reported Baseline=NVSS 1999
• Patients with implantable devices • Class I and II heart failure patients • Patients with coronary artery disease after
complete revascularization • Patients with stable angina with satisfactory
2005
2006
2007
AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic
Vascular Disease: 2006 Update
• Lifestyle modification • Blood pressure control • Lipid management • Diabetes management • Antithrombotic treatment • Renin-Angiotensin-Aldosterone system blockade • β –blockers • Influenza vaccination
Lifestyle modification
• Smoking
-complete cessation, avoid environmental exposure
• Physical activity -30 minutes, 7 days per week (minimum 5 days per week)
400,000 300,000 200,000 100,000
0
57% of deaths due to CV diseases
All Ages
<85
85+
Alzheimer CLRD Cancer Other CVD Stroke Heart Disease
CVD and other major causes of death: both sexes. (United States: 2004). Source: NCHS and NHLBI.