抗高血压药物引起的糖尿病不容忽视(英文).ppt
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1、DRUG INDUCED DIABETES DURING ANTIHYPERTENSIVE THERAPY IS IMPORTANT - BUT,CHINESE SOCIETY OF HYPERTENSION MICHAEL ALDERMAN MAY 22, 2008,Prevalence of diabetes among Chinese adults aged 3564 years in the 1994 Chinese National Survey (10) and 20002001 InterASIA Study,Gu et al Diabetologia. 2003;46:1190
2、.,Percent of deaths,Geiss LS, et al. In: Diabetes in America. National Institutes of Health;1995.,65% of Mortality in people with Diabetes is CVD,Ischemic heart disease,Other heart disease,Diabetes,Malignant neoplasms,Cerebrovascular disease,Pneumonia/ influenza,All other,CV mortality rate per 10,00
3、0 person-years,Systolic BP and CV Death in MRFIT,Nondiabetic (n=342,815),Diabetic (n=5,163),120,120-139,Systolic BP (mmHg),140-159,160-179,180-199,200,Stamler J, et al. Diabetes Care. 1993;16:434-444.,BP= blood pressure CV=cardiovascular MRFIT=Multiple Risk Factor Intervention Trial,Annual Incidence
4、 of Diabetes in Hypertensive Patients,SHEP 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,NHANES 18 year Follow-up NOD in US Women by Baseline BP,Conen, D. et al. Eur Heart J 2007 28:2937-2943,120,
5、120-129,130-139,140,mmHg,.,Conen, D. et al. Eur Heart J 2007 28:2937-2943,Age-adjusted incidence rates (A) and HRs (B) of NOD according to blood pressure category, stratified by baseline body mass index,THE ISSUES,CONSEQUENCES OF NOD CVD AND non-CVD HOW DO ANTIHYPERTENSIVE DRUGS EFFECT INCIDENCE OF
6、NOD AND CVD ONSEQUENCES? HOW SHOULD NOD EFFECT MANAGEMENT FOR CVD PROTECTION?,Non-CVD Consequences of NOD,Impaired BP control Behavioral and Psychological Microvascular consequences (?) Medical care demands Treatment changes,CVD Consequences,Short and Long term Antihypertensive Drug Related,.,Whelto
7、n, P. K. et al. Arch Intern Med 2005;165:1401-1409.,ALLHAT Incidence of Coronary heart disease by treatment group according to baseline diabetes mellitus, impaired fasting glucose level, or normoglycemia,Barzilay, J. I. et al ALLHAT. Arch Intern Med 2006;166:2191-2201.,HRs of a 10-mg/dL (0.56-mm) FB
8、G at 2 years for subsequent CVD and Renal Disease,Effect of ACEIs and ARBs on CVD Mortality,Gillespie, et al. Diabetes Care 28:2261-2266, 2005,Age-genderadjusted in treatment CVD and non-CVD by baseline FBG among hypertensive patients.,Alderman, Hypertension. 1999;33:1130-1134,Myocardial infarction
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