高血壓心血管事件的臨床研究(ppt51)英文-經(jīng)營管理(編輯修改稿)
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【文章內(nèi)容簡介】 l Events VA Cooperative Study Group. JAMA. 1970。213:11431152. *P active drug therapy vs placebo 來自 The VA Cooperative Study, 1970: Conclusions ? Active treatment reduced fatal and nonfatal endpoints ? A subsequent analysis revealed that benefits were statistically significant only for those with baseline diastolic blood pressure 105114 mmHg VA Cooperative Study Group. Circulation. 1972。 45 (5):9911004. VA Cooperative Study Group. JAMA. 1970。213:11431152. The European Working Party on High Blood Pressure in the Elderly, 1985 來自 The European Working Party on High Blood Pressure in the Elderly, 1985 Cohort 840。 30% men Age 60 yrs old。 mean 72 yrs old Eligibility Systolic BP 150?239 mmHg。 diastolic BP 90?119 mmHg Design Double blind。 placebo control Therapy HCTZ, triamterene Duration years BP change 21/10 mmHg at 5 years Amery A, et al. Lancet. 1985。1:13491354. 來自 708090100Survival free of event (%) Year of followup EWPHE Cardiovascular Mortality OnTreatment Analysis Active (n=416) Placebo (n=424) P= 0 1 3 6 2 4 5 7 Amery A, et al. Lancet. 1985。1:13491354. Reprinted with permission from Elsevier Science. EWPHE=European Working Party on High Blood Pressure in the Elderly 來自 EWPHE Conclusions ? Active treatment reduced cardiovascular (CV) mortality, largely due to a reduction in cardiac mortality ? Older patients (60 yrs old) with bined systolic and diastolic hypertension who received active therapy experienced 29 fewer CV events and 14 fewer CV deaths per 1,000 patientyears of treatment Amery A, et al. Lancet. 1985。1:13491354. EWPHE=European Working Party on High Blood Pressure in the Elderly The Hypertension Detection and Followup Program, 1979 來自 The Hypertension Detection and Followup Program, 1979 Cohort 10,940。 54% men。 44% black Age 30?69 yrs old。 mean yrs old Eligibility Diastolic BP ? 90 mmHg Design Stepped Care vs Referred Care Therapy Chlorthalidone (reserpine, methyldopa) Duration 5 years BP change 5 mmHg (Stepped Care vs Referred Care) HDFP Cooperative Group. JAMA. 1979。242:25622571. 來自 02468Cumulative mortality (%) 0 1 3 6 Year of followup HDFP Mortality Rates Entire Cohort 2 4 5 Referred Care Stepped Care HDFP=Hypertension Detection and Followup Program *P HDFP Cooperative Group. JAMA. 1979。242:25622571. (n=5,456) (n=5,485) * 來自 024680 1 3 6 2 4 5 Cumulative mortality (%) HDFP Mortality Rates Diastolic BP 90?104 mmHg Referred Care Stepped Care HDFP=Hypertension Detection and Followup Program Year of followup *P HDFP Cooperative Group. JAMA. 1979。242:25622571. (n=3,822) (n=3,903) * BP=blood pressure 來自 HDFP Conclusions ? Overall, stepped care (SC) pared to referred care (RC) reduced total mortality by 17% ( vs. %。 P) ? In patients with baseline diastolic blood pressure 90?104 mmHg (n=7,725), mortality was reduced by 20% with SC vs. RC (% vs. %。 P) ? Aggressive treatment of SC patients with the lowest baseline diastolic blood pressures (90?94 and 95?99 mmHg) reduced mortality HDFP=Hypertension Detection and Followup Program HDFP Cooperative Group. JAMA. 1979。242:25622571. The Systolic Hypertension in the Elderly Program, 1991 來自 The Systolic Hypertension in the Elderly Program, 1991 SHEP Research Group. JAMA. 1991。265:32553264. Cohort 4,73
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