抗高血壓藥物引起的糖尿病不容忽視(英文)-資料下載頁(yè)
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【正文】 ,140,150,160,170,Myocardial infarction,Microvascular endpoints,Microvascular endpoints,Myocardial infarction,Adler AI, et al. BMJ. 2000。321:412419. Stratton IM, et al. BMJ. 2000。321:405412. .,MI=myocardial infarction SBP=systolic blood pressure,UNCERTAINTY CONTINUES ACCORD AND ADVANCE,ACCORD Mortality greater with HbAlc 6.4 v. 7.07.9% ADVANCE No evidence of ? mortality with HbAlc 6.4 v. 7,5%,Major CV Event Rate In HOT,HOT,Lancet 1998。351:1755,p = 0.005 51% risk reduction,Goal Diastolic mmHg,Diabetic population,NonDiabetic subjects,CONCLUSIONS,DM serious whenever it occurs More common in hypertensive Rx Particularly with diuretics NOD has consequences NonCVD in short term CVD long term Neither fear of, nor NOD, requires D/C Diuretic,CLINICAL IMPLICATIONS,SCREEN FOR NOD ATTEMPT TO REVERSE HYPERGLCEMIA CORRECT HYPOKAELMIA K SPARING DIURETIC ADD ACE OR ARB OPTIMIZE BP AND LIPID CONTROL TREAT HYPERGLYCEMIA (?) NO EVIDENCE OF CVD BENEFIT PREVENTION OF MICROVASCULAR EFFEC
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