【高血压英文精品课件】Get to Goal, Achieve control.ppt

- A direct relationship has been shown between the maximum home systolic blood pressure and left ventricular mass index (figure A) as well as the degree of carotid intima-media thickness (figure B). * * * * * Historically, efforts to control BP and limit associated morbidity and mortality have focused on DBP.1 A community-based sample from the Framingham Heart Study showed that control of SBP is more difficult among patients with hypertension1: As this slide shows, 67% of hypertensive patients had SBP above the goal of 140 mmHg1 In contrast, elevated DBP (90 mmHg) was observed in only 17% of patients1 These findings suggest that greater emphasis should be placed on helping hypertensive patients—especially those who are older, obese, or have target-organ damage—achieve goal SBP.1 Context: This analysis included data for 1959 hypertensive patients in the Framingham Heart Study, an ongoing, prospective epidemiologic cohort study designed to evaluate the impact of risk factors on coronary heart disease. These patients were examined between 1990 and 1995 for hypertension defined on the basis of SBP of 140 mmHg or greater, DBP of 90 mmHg or greater, or the use of antihypertensive medication. The mean patient age was 66 years; 54% were women and 60.7% were receiving antihypertensive medication.1 Reference Lloyd-Jones DM, Evans JC, Larson MG, et al. Differential control of systolic and diastolic blood pressure: factors associated with lack of blood pressure control in the community. Hypertension. 2000;36:594–599. Ref 1, p 595, C1, ?2, L1-4; p 596, Fig 1 Ref 1, p 594, C2, ?1, L3-5 Ref 1, p 595, C1, ?1, L1-3, C2, ?2, L4-8; p 598, C1, ?1, L3,4 Ref 1, p 596, Fig 1 Ref 1, p 596, Fig 1 + calc Calc: 13.4+3.7=17.1 Ref 1, p 598, C1, ?1, L5-8 Ref 1, p 595, C1, ?1, L1-3, ?2, L1-4, C2, ?1, L1,2, ?2, L1,2 The results of this observational prospective cohort study, which followed patients (65 years or older) for 10 years, demonstrated a strong and independent association betwee