【正文】
tiplatelet: control 0 Antiplatelet better Antiplatelet worse 血糖控制,降低了心血管危險,但強(qiáng)化治療并不優(yōu)于標(biāo)準(zhǔn)治療 Duckworth W et al. NEJM 2022。360:129139 Primary oute Probability of survival 0 2 4 6 8 Years P= Intensive therapy Standard therapy 899 892 Standard therapy Intensive therapy 770 774 693 707 637 639 570 582 471 510 240 252 55 62 0 0 No. at risk 降血壓降 CV 風(fēng)險 –5 0 5 10 15 20 25 SBP reduction (mmHg) actively controlled trials placebocontrolled studies or trials with an untreated control group STOP2/ACEIs MRC2 MIDAS/NICS/VHAS UKPDS C vs A NORDIL INSIGHT HOT L vs H HOT M vs H MRC1 HEP EWPHE STOP1 ATMH PART2/SCAT CAPPP SystChina SystEur STONE UKPDS L vs H RCT7080 P= HOPE SHEP STOP2/CCBs Relative risk of cardiovascular death Staessen et al. Hypertens Res. 2022。28:385407 0 1 2 ?23% (2%, 40%) P= Risk Reduction Carvedilol n=975 Placebo n=984 Years β阻滯劑降 CV風(fēng)險 Allcuse mortality (Proportion Eventfree) The CAPRICORN Investigators. Lancet. 2022。357:13851390. RAS 阻滯劑降 CV 風(fēng)險 勝于血壓控制 1 7 . 8141 4 . 81302468101214161820Pl a c e b o R a m i p r i l Pl a c e b o T e l m i s a r ta nTRANSCEND* HOPE* 39。HOPE39。 endpoint event rate (%) * Assessed using the same posite endpoint = CV death + MI + stroke (., HOPE primary posite endpoint) Yusuf S, et al. N Engl J Med 2022。342:145–153。 The TRANSCEND Investigators. Lancet 2022。 372:117483. n=9,297 5,926 P P= 結(jié)論 1. 心血管疾病在全球范圍內(nèi)高發(fā)病率和死亡率 2. 心血管疾病是漸進(jìn)的,通過各種傳統(tǒng)和新危險因素,其高風(fēng)險和事件序貫而至。 3. 諸如下列藥物等措施可有效的處理 CV高?;颊?,可以減少心血管事件的風(fēng)險。 ? 他汀類藥物 ? 抗血小板制劑 ? 控制血糖抗高血壓藥 ? β阻斷劑 ? RAS阻滯劑