心血管病预防—培训课件.ppt

* * * * * * * 参考答案：啤酒250克略小于250ml，即常见普通瓶装啤酒的小半瓶，或易拉罐的2/3罐 * * 参考答案：个人“控盐” 没必要也没办法弄得太机械。世界卫生组织把日荐摄盐量降低1克主要还是为了向人们传达一个限盐和低钠饮食的理念。在短期之内，让人们每日摄盐限制在5克以内不太现实，但至少大家应该有这个意识，去无限地接近这个目标。 * * 毛主席：“基本吃素，提倡走路” * * * * * * * * * 胆固醇水平的升高必然会导致临床事件的增加。在对北京市所做的一项研究中，从1984年到1999年，新增了1882例冠心病死亡，导致新增死亡事件的原因中，胆固醇水平升高负有77％的责任。 * 人体内胆固醇有2个来源：即合成和吸收。包括肝脏（肝脏生物转化）、肠道、肾上腺皮质和生殖组织在内的人体内所有组织均能合成胆固醇。肠道中的胆固醇来源于饮食和胆汁，并经肠道吸收和转运到达肝脏。据估计，对于低胆固醇饮食的个体，肝脏每天生成约800mg以替代胆盐及胆固醇从粪便的排出。约有1000mg胆固醇从肝脏分泌入胆管（约占肠道胆固醇的2/3）。每日胆固醇的摄入取决于饮食，通常范围在 300-700 mg/d （约占肠道胆固醇的1/3） 。因此，每天约有1300-1700mg的胆固醇经过肠道，其中约一半被重吸收回肝脏。 * Emberson J et al, used estimates of the relative risk reductions from meta-analyses of randomised trials in combination with data from a prospective observational study of CVD (the British Regional Heart Study) to analyse the impact of different risk reduction strategies in primary prevention. The study examined the effects of prevention strategies based on single risk factor assessment or total risk assessment. They concluded that assessment of overall risk leads to more effective intervention than assessment based on single risk factors. Furthermore, multiple interventions have considerably greater benefits than interventions based on targeting single risk factors. Ten percent reductions in long-term mean blood cholesterol and BP could have reduced major CVD by 45%. Jackson R et al, conducted a review of the randomised trials of BP or blood cholesterol lowering treatments and outlined the rationale for targeting BP and blood cholesterol lowering therapy to patients at high absolute CV risk. They concluded that separate management guidelines for raised BP and blood cholesterol need to be replaced by integrated CV risk management guidelines. They also posited that because CV risk factors interact with each other, moderate reductions in several risk factors can be more effective than major reductions in one. References 1. Emberson J, Whincup P, Morris R, Walker M, Ebrahim S. Evaluating the impact of populati