抗高血压药物引起的糖尿病不容忽视英文
预防糖尿病英语作文
预防糖尿病英语作文英文回答：Preventing diabetes is crucial for maintaining a healthy life and reducing the risk of developing serious complications. Here are some effective ways to prevent diabetes:1. Maintain a Healthy Weight:Obesity is a major risk factor for diabetes. Aim for a healthy body weight by eating a balanced diet and engaging in regular physical activity.2. Engage in Regular Exercise:Exercise helps improve insulin sensitivity and lower blood sugar levels. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.3. Follow a Healthy Diet:Choose foods rich in fiber, fruits, vegetables, and whole grains. Limit your intake of processed foods, sugary drinks, and unhealthy fats.4. Quit Smoking:Smoking damages blood vessels and interferes with insulin sensitivity. Quitting smoking can significantly reduce your risk of diabetes.5. Get Enough Sleep:Sleep deprivation can lead to hormonal imbalances that increase insulin resistance. Aim for 7-9 hours of quality sleep each night.6. Manage Stress:Chronic stress can elevate blood sugar levels. Findhealthy ways to manage stress, such as exercise, yoga, or meditation.7. Regular Medical Checkups:Regular checkups can help identify early signs of diabetes and allow for timely intervention. Get tested for diabetes regularly, especially if you have risk factors.8. Genetic Counseling:If you have a family history of diabetes, consider genetic counseling to assess your risk and develop preventive strategies.9. Use Insulin Sensitizers:Certain medications, such as metformin, can improve insulin sensitivity and help prevent diabetes in high-risk individuals.10. Avoid Environmental Toxins:Exposure to certain environmental toxins, such as phthalates and BPA, has been linked to an increased risk of diabetes. Limit your exposure to these toxins.中文回答：预防糖尿病。
抗高血压药课件英文版
contents
目录
• The latest research progress of antihypertensive drugs
• Non pharmacological therapy and lifestyle adjustments
• Self management and monitoring of hypertensive patients
Children
Children should only be subscribed antihypertensive drugs under exceptional circumstances, as most cases of hypertension in children can be controlled through lifestyle changes
Pre gnant women
Pre gnant women should only be pre subscribed anti hypertensive drinks if absolutely necessary, and they should be closely monitored during pre gnancy
VS
Common ARBs include losartan, valsartan, and irbesartan
Calcium channel antagonists (CCBs)
CCBs are drugged that block the entry of calculus into the heart and blood vessels, then relaxing the smooth muscle in the walls of blood esistance
Coronary heart disease
Subendocardial MI (心内膜下心肌梗死)和 transmural MI（透壁性心肌梗死 ）
Micrograph of Myocardial infarction
Myocardial fibrosis
Sudden coronary death
冠状动脉性猝死
Treatment
• 1. Coronary artery bypass grafting ， CABG(冠状动脉搭桥 术) • 2.Conventional medical treatment （常规药物治疗） • 3.Intervention(介入 疗法)
Myocardial infarction,MI
• Classification • 1.Subendocardial myocardial infarction心内膜下心肌梗死 • 2.Transmural myocardial infarction透 壁性心肌梗死 • Complication并发症 • 1.Heart failure,HF • 2.Heart rupture • 3.Ventricular aneurysm（室壁瘤）
Coronary heart disease
冠心病
Causes
• Coronary artery disease has a number of well determined risk factors. The most common risk factors include smoking, family history, hypertension高血压, obesity肥胖, diabete糖尿病, high alcohol consumption大量饮酒, lack of exercise, stress, and hyperlipidemia高 脂血.Smoking appears to be the cause about 36% of cases and obesity 20%. Lack of exercise has been linked to 7-12% of cases. Job stress appear to play a minor role accounting for about 3% of cases. In one study, women who were free of stress from work life saw an increase in the diameter 直径of their blood vessels, leading to atherosclerosis动脉粥样硬化.Contrastingly, women who had high levels of work-related stress experienced a decrease in the diameter of their blood vessels. Also, having a type A behavior pattern, a group of personality characteristics including time urgency, competitiveness, hostility, and impatience is linked to an increased risk of coronary disease. Parental history of high blood pressure can also contribute to a higher risk of heart disease in an individual. People whose parents are hypertensive have greater systolic and diastolic blood pressure numbers when compared with individuals without hypertensive parents. High blood pressure has been shown to be a cause of heart disease.
预防糖尿病英语作文120字
预防糖尿病英语作文120字英文回答：Preventing diabetes requires a holistic approach that encompasses lifestyle modifications and medical interventions. Here are some key strategies:Dietary Changes:Limit sugary drinks and processed foods.Opt for whole grains, fruits, and vegetables.Choose lean proteins and healthy fats.Moderate portion sizes and monitor calorie intake.Physical Activity:Engage in regular exercise (at least 150 minutes perweek)。
Incorporate brisk walking, jogging, cycling, or swimming into your routine.Aim for activities that increase heart rate and promote sweating.Weight Management:Maintain a healthy body weight.Avoid drastic weight loss or gain.Set realistic weight loss goals and consult with a healthcare professional.Other Lifestyle Factors:Quit smoking.Reduce alcohol consumption.Manage stress levels through techniques like meditation or yoga.Get adequate sleep (7-9 hours per night)。
中文翻译Misconceptions about High-Fructose Corn Syrup…
关于高果糖玉米糖浆的误解：作为活性羰基化合物和晚期糖基化终产物的它具 有引起肥胖的独特性质？John S. White文摘在科学文献中误解高果糖玉米糖浆(HFCS)的文章比比皆是,因此卫生专业人员建议他们的病人不要因 为媒体报道和产品广告而做出不理性的消费行为。
在这些误解中最严重的是高果糖玉米糖浆具有导致 肥胖危机的真实的独特性质。
不准确的信息从表面上看是在极端实验条件下收集的具有可靠来源和研 究数据的选择性表达,既不代表人类饮食和高果糖玉米糖浆,误导无知和创建一种不信任的气氛,避免 什么,所有权利,应考虑安全、无害的甜味剂。
在本文的第一部分,常见误区的组成、功能,新陈代谢,并 使用氢氟碳化合物及其传说与肥胖联系确定并纠正。
在第二部分中,一个新兴的误解,HFCS 在碳酸软 饮料物质有助于生理水平的活性二� � � 基化合物和先进的晚期,详细讨论,提出了证据,HFCS 并不构 成独特的饮食健康个体的风险或糖尿病患者。
介绍肥胖及相关疾病是一个重要的和不断增长的健康问题在美国和世界各地。
美国疾病控制和预防中心估 计,> 33%的美国人年龄在 20 - 74 现在肥胖(1)。
追求导致肥胖的原因是首要研究,以便可以采取措施 扭转这种趋势。
尽管肥胖的主要原因是能量摄入和能量 expenditure-much thermodynamic-an 失衡研究侧重于其他贡献的原因。
程序在任何卫生专业协会的年度会议上显示与肥胖相关的全面研究, 数以百计的潜在原因考虑。
然而,1 传说引起肥胖的已经超过了许多人:果糖和 fructose-containing 甜味剂。
使用一个特定的 fructose-containing 甜味剂,高果糖玉米糖浆(HFCS),3 一直弱与肥胖和相关疾病的 风险增加有关美国(2)。
尽管最初是作为一个简单的假设,本协会已经在许多公众的思想,媒体,和医疗 保健行业相信高果糖玉米糖浆是惟一负责肥胖,也就是说,除了其基本能源贡献的食物。
有效治疗糖尿病的英文作文
有效治疗糖尿病的英文作文Diabetes is a serious health problem that affects millions of people worldwide. There are several ways to treat diabetes effectively. Firstly, a healthy diet is crucial. It's important to limit sugar and carbohydrate intake and focus on whole grains, lean proteins, and plenty of fruits and vegetables. Secondly, regular exercise can help control blood sugar levels and improve overall health. It doesn't have to be intense even a daily walk can make a difference. Thirdly, medication may be prescribed by a doctor to help regulate blood sugar. It's important to take it as directed. Finally, monitoring blood sugar levels regularly is essential to ensure that treatment is working. With the right combination of these approaches, many people with diabetes are able to manage their condition and live healthy lives.Another important aspect of diabetes management is stress reduction. Chronic stress can raise blood sugar levels, so finding ways to relax and de-stress is crucial. This could include activities like meditation, yoga, or deep breathing exercises. Additionally, getting enough sleep is important for overall health and can also help regulate blood sugar. Aim for 7-8 hours of sleep per night.It's also important for people with diabetes to stay up-to-date on the latest research and treatment options. This can involve talking to a doctor, attending diabetes education classes, or joining a support group. Sharing experiences and tips with others who have diabetes can be helpful and empowering.In conclusion, there are many ways to effectively treat diabetes. A combination of a healthy diet, regular exercise, medication, stress reduction, and monitoring blood sugar levels is often the most effective approach. By taking an active role in their own health, people with diabetes can manage their condition and live full, healthy lives.。
预防糖尿病英语作文
预防糖尿病英语作文English:Preventing diabetes is essential for maintaining good health and quality of life. One of the most important ways to prevent diabetes is by adopting a healthy lifestyle. This includes eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, and avoiding excessive consumption of sugary and processed foods. Regular physical activity is also crucial in preventing diabetes, as it helps control weight, improves insulin sensitivity, and reduces the risk of developing the disease. Additionally, maintaining a healthy weight and managing stress levels are important factors in preventing diabetes. It is also recommended to avoid smoking and limit alcohol consumption, as these habits can increase the risk of developing diabetes. Regular check-ups with healthcare providers to monitor blood sugar levels, blood pressure, and cholesterol are essential for early detection and prevention of diabetes. By making these lifestyle changes and taking proactive measures, individuals can significantly reduce their risk of developing diabetes and improve their overall health and well-being.中文翻译:预防糖尿病对于保持健康和生活质量至关重要。
高血压、糖尿病等医学专业英语重点词汇
高血压、糖尿病等医学专业英语重点词汇全文共10篇示例，供读者参考篇1High blood pressure and diabetes are two common medical conditions that many people face. Let's take a closer look at these two health issues and understand them better.First, let's talk about high blood pressure. High blood pressure, also known as hypertension, is when the force of blood against the walls of your arteries is consistently too high. This can lead to serious health problems, such as heart disease, stroke, and kidney failure. It's important to keep your blood pressure under control by eating a healthy diet, exercising regularly, and taking any prescribed medications.Now, let's move on to diabetes. Diabetes is a condition where your blood sugar levels are too high. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is when your body doesn't produce enough insulin, a hormone that helps regulate blood sugar. Type 2 diabetes is when your body doesn't use insulin properly. Both types of diabetes can lead to serious complications if not managed properly.To prevent high blood pressure and diabetes, it's important to live a healthy lifestyle. This includes eating a balanced diet, staying active, maintaining a healthy weight, and avoiding smoking and excessive alcohol consumption. Regular check-ups with your doctor can also help catch any potential issues early on.So, remember to take care of your health and listen to your body. High blood pressure and diabetes are serious conditions, but with the right knowledge and actions, you can manage them effectively. Stay healthy and happy!篇2Title: Let's Learn about High Blood Pressure and Diabetes!Hey guys! Today, let's talk about some fancy words that are related to our health - high blood pressure and diabetes. These are two common health conditions that can affect adults, but it's good for us to know about them too!First, let's chat about high blood pressure. It's also called hypertension. What happens is that the force of the blood against the walls of our blood vessels is too high. This can cause damage to our heart, blood vessels, and other organs. We wantto keep our blood pressure in check, so it's important to eat healthy foods, exercise, and avoid salty snacks.Next up is diabetes. There are two types of diabetes - type 1 and type 2. In type 1 diabetes, the body doesn't make enough insulin, which is a hormone that helps regulate blood sugar. In type 2 diabetes, the body doesn't use insulin properly. Both types can cause high blood sugar levels, which can lead to serious health problems if left untreated. To prevent diabetes, we should eat a balanced diet, exercise regularly, and limit sugary treats.It's important to go for regular check-ups with the doctor to monitor our blood pressure and blood sugar levels. If you have a family history of high blood pressure or diabetes, it's even more important to stay on top of your health. Remember, prevention is key!So there you have it, guys! High blood pressure and diabetes may sound like big words, but with a little bit of knowledge and some healthy habits, we can keep ourselves feeling our best. Take care of your health, and don't be afraid to ask questions if you're not sure about something. Stay healthy, friends!篇3Hey guys, today we are going to talk about some really important stuff! Do you know what high blood pressure and diabetes are? Well, let me tell you all about it in a fun and easy way.First, let's talk about high blood pressure. It is also called hypertension. When your blood pressure is too high, it can cause all sorts of problems like heart disease, stroke, and kidney failure. So, it's super important to keep your blood pressure in check by eating healthy foods, not smoking, and exercising regularly.Next, let's chat about diabetes. It's a condition where your body can't properly use the sugar in your blood. This can lead to all sorts of complications like nerve damage, kidney problems, and even blindness. The best way to manage diabetes is by eating a balanced diet, exercising, and taking medication as prescribed by your doctor.So guys, remember to take care of your health by eating well, staying active, and getting regular check-ups with your doctor. And if you ever have any questions about high blood pressure or diabetes, don't hesitate to ask an adult or your school nurse. Stay healthy, everyone!篇4Hello everyone, today I want to talk about some important medical terms that we hear a lot but may not fully understand. These words are "hypertension" and "diabetes". Sounds like big words, right? But don't worry, I'll explain them in a way that we can all understand.Let's start with hypertension. Hypertension is a fancy word for high blood pressure. It means that the force of blood pushing against the walls of your blood vessels is too high. When this happens, it can be bad for your heart and other parts of your body. So, if you have hypertension, it's important to follow your doctor's advice on how to keep it under control. This might include eating healthy foods, exercising, and taking medicine if your doctor prescribes it.Now, let's talk about diabetes. Diabetes is a condition where your body has trouble using sugar for energy. This can happen if your body doesn't make enough insulin (a hormone that helps sugar get into your cells) or if your body doesn't use insulin properly. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes usually starts in childhood and means your body doesn't make insulin at all. Type 2 diabetes is more common in adults and means your body doesn't use insulin well. Both typesof diabetes need to be managed carefully to keep your blood sugar levels in check.So, remember to eat healthy, stay active, and see your doctor regularly to keep your blood pressure and blood sugar under control. These are important things to know about to stay healthy and happy. Thanks for listening!篇5Hello everyone! Today, I'm going to talk to you about some important medical words - high blood pressure and diabetes!First, let's talk about high blood pressure. High blood pressure is when the force of blood against your artery walls is too high. It can be caused by things like not eating healthy food, not exercising enough, or even genetics. If you have high blood pressure, you may feel dizzy, have headaches, or even have a heart attack. It's really important to take care of your body and try to keep your blood pressure at a healthy level by eating well, exercising, and listening to your doctor.Now, let's talk about diabetes. Diabetes is when your body can't properly use or make insulin, which is a hormone that helps your body turn sugar from food into energy. There are two main types of diabetes - type 1 and type 2. Type 1 diabetes is whenyour body doesn't make insulin at all, and type 2 diabetes is when your body doesn't use insulin properly. Some symptoms of diabetes include feeling thirsty all the time, peeing a lot, and feeling tired. It's really important to manage your diabetes by eating healthy foods, checking your blood sugar levels, and taking any medicine your doctor prescribes.So, remember to take care of your body and listen to your doctor if you ever have high blood pressure or diabetes. Stay healthy, everyone!篇6High blood pressure and diabetes are two common health issues that many adults face. Even though these words might sound super difficult, don't worry! I'm here to explain them in a simple and fun way.Let's start with high blood pressure. When we talk about high blood pressure, we're actually talking about how hard our hearts have to work to pump blood around our bodies. It's like when you blow up a balloon really hard - your muscles have to work extra to keep the balloon inflated. The same thing happens with our hearts when our blood pressure is high.To keep our blood pressure in check, we can eat healthy foods like fruits and veggies, exercise regularly, and avoid too much salt in our diets. It's also important to visit the doctor regularly so they can check our blood pressure and make sure everything is A-OK!Now, let's move on to diabetes. Diabetes happens when our bodies have trouble using sugar properly. It's like when you try to put too much syrup on your pancakes - your body doesn't know what to do with all that sugar, and things can get a bit messy.People with diabetes need to be extra careful about what they eat and how much they exercise. They also have to check their blood sugar levels regularly to make sure everything is running smoothly. But with the help of doctors and healthy habits, people with diabetes can live happy and healthy lives!So, there you have it - high blood pressure and diabetes explained in a way that even us kids can understand. Remember, taking care of our bodies is super important, so let's all make an effort to stay healthy and strong!篇7Hi guys, today let's talk about some important medical terms like high blood pressure and diabetes. These are serious conditions that we need to know about to stay healthy.High blood pressure, also known as hypertension, is when the force of blood against the walls of your blood vessels is consistently too high. This can lead to heart attacks, strokes, and other serious health problems. To keep our blood pressure in check, it's important to eat healthy, exercise regularly, and avoid smoking and too much salt.Now, let's talk about diabetes. Diabetes is a condition where your body either doesn't make enough insulin or can't use the insulin it does make properly. Insulin is a hormone that helps regulate blood sugar levels. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is when your body doesn't make insulin at all, and type 2 diabetes is when your body doesn't use insulin properly.To prevent diabetes, it's important to eat a balanced diet, exercise regularly, and maintain a healthy weight. If you have diabetes, it's important to monitor your blood sugar levels and take your medication as prescribed by your doctor.Remember, it's important to take care of our bodies and stay healthy. By understanding these medical terms and taking stepsto prevent them, we can live happy and healthy lives. Thanks for listening!篇8High blood pressure and diabetes are two common medical conditions that many adults have to deal with. But what are they exactly and why are they so important to pay attention to? Let's break it down in simple terms.First, let's talk about high blood pressure, or hypertension. This means that the force of blood against the walls of your arteries is consistently too high. It can be caused by a variety of factors such as genetics, diet, stress, and lack of exercise. If not managed properly, high blood pressure can lead to serious health problems like heart disease, stroke, and kidney damage.Next, let's discuss diabetes. Diabetes is a condition where your blood sugar levels are consistently too high. There are two main types of diabetes - Type 1 and Type 2. Type 1 diabetes is usually diagnosed in children and young adults and is not preventable. Type 2 diabetes, on the other hand, is more common in adults and is often linked to lifestyle factors like poor diet and lack of exercise.Both high blood pressure and diabetes require regular monitoring and management by a healthcare professional. This may include taking medication, making lifestyle changes like eating a healthy diet and exercising regularly, and monitoring your blood pressure and blood sugar levels.It's important to remember that high blood pressure and diabetes are serious conditions that can have serious consequences if not properly managed. So be proactive about your health, listen to your doctor's recommendations, and take care of yourself so you can live a long and healthy life.篇9Hey guys, do you know about high blood pressure and diabetes? They are two common medical conditions that we need to know about. Let’s learn some key points about them in a fun and easy way!First, let’s talk about high blood pressure. High blood pressure, also known as hypertension, is when the force of blood against the walls of your blood vessels is consistently too high. This can lead to serious health problems like heart disease, stroke, and kidney disease. To keep your blood pressure undercontrol, it’s important to eat healthy foods, exercise regularly, and avoid salty and fatty foods.Next, let’s learn about diabetes. Diabetes is a condition where your blood sugar levels are too high because your body either can’t produce enough insulin (a hormone that helps regulate blood sugar) or can’t use insulin effectively. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is usually diagnosed in children and young adults and is when the body doesn’t produce insulin. Type 2 diabetes is more common in adults and is when the body can’t use insulin properly.To prevent diabetes, it’s important to maintain a healthy lifestyle by eating a balanced diet, exercising regularly, and managing your weight. If you have diabetes, it’s important to monitor your blood sugar levels regularly, take your medication as prescribed, and see your doctor regularly.Remember, taking care of your health is super important! So let’s eat well, exercise, and take care of our bodies so we can stay healthy and strong. Thanks for listening, guys!篇10Hey guys, today I want to talk to you about some important medical terms that you may have heard about but may not fullyunderstand. These terms are high blood pressure and diabetes. Let's break it down together!High blood pressure, also known as hypertension, is when the force of blood against the walls of your arteries is consistently too high. This can cause damage to your blood vessels and organs over time. It's important to monitor your blood pressure regularly and make healthy lifestyle choices like eating well and exercising to keep it under control.Diabetes is a condition where your body either doesn't produce enough insulin (a hormone that helps regulate blood sugar) or can't use it effectively. This results in high levels of sugar in your blood, which can lead to serious health problems if not managed properly. People with diabetes need to monitor their blood sugar levels, take medication as prescribed, and follow a healthy diet and exercise routine.Remember, it's important to take care of your health and listen to your body. If you have any concerns about high blood pressure or diabetes, talk to a doctor or healthcare professional. They can help you understand these conditions better and work with you to create a plan for staying healthy.Stay informed, stay healthy, and take care of yourselves!。
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10
45
0
Dream. 2N0E2J0M/9/;23355:1551-1562,2006
Ramipril v. Placebo CVD & non-CVD Outcomes
Dream. NEJM;355:1551-1562,2006
2020/9/23
ALLHAT: RR (and 6-year rates per 100 for nondiuretic compared with diuretic for diabetes mellitus (A), impaired fasing glucose level (B), and normoglycemia (C) at baseline, for CHD, all-
2020/9/23
Non-CVD Consequences of NOD
• Impaired BP control • Behavioral and Psychological • Microvascular consequences (?) • Medical care demands • Treatment changes
No Image
Al2d0e2r0m/9/a2n3 , Hypertension. 1999;33:1130-1134
Myocardial infarction (fatal and nonfatal) in hypertensive patients according to DM status
15 13 13
10
10
4
5
0
G2u020e/9/t23al Diabetologia. 2003;46:1190.
Percent of deaths
65% of Mortality in people with Diabetes is CVD
50
40
40
30
20
15
13
13
10
10
4
5
0
Geiss LS, et al. In: Diabetes in America. Nat2i0o2n0/a9/l23Institutes of Health;1995.
130-139
>140
Age-adjusted incidence rates (A) and HRs (B) of NOD according to blood pressure category, stratified by baseline body mass index
. Conen2, 0D2.0e/9t/2a3l. Eur Heart J 2007 28:2937-2943
Goal Diastolic mmHg
Lan2c0e2t0/19/9293 8;351:1755
CONCLUSIONS
• DM serious whenever it occurs
– More common in hypertensive Rx
– Particularly with diuretics
* *
* p<.05 compared to chlorthalidone
2020/9/23
JAMA 2002;288:2981-2997
Ramipril v. Placebo in high risk patients with IGT at baseline
50
40
40
30
20
15 13 13 10
THE ISSUES
• CONSEQUENCES OF NOD
– CVD AND non-CVD
• HOW DO ANTIHYPERTENSIVE DRUGS EFFECT INCIDENCE OF NOD AND CVD ONSEQUENCES?
• HOW SHOULD NOD EFFECT MANAGEMENT FOR CVD PROTECTION?
2020/9/23
Prevalence of diabetes among Chinese adults aged 35–64 years in the 1994 Chinese
National Survey (10) and 2000–2001 InterASIA Study
50
40
40
30
20
Annual Incidence of Diabetes in Hypertensive Patients
• SHEP untreated controls = 2.7% • SHEP treated = 3.9%
Lanc2e0t2.02/90/0263, 368;1673-1679, Am J Cardiol. 2005;95:29,Hypertension.2007;50:467, JAMA 2002;288:2981-2997
2020/9/23
HOT
Major CV Event Rate In HOT
Non-Diabetic subjects
Diabetic population
No
p = 0.005 51% risk reduction
Image
85.2 83.2 81.1 DBP achieved
< 90 < 85 < 80 < 90 < 85 < 80
• The diabetes related to chlorthalidone therapy has better prognosis than diabetes at baseline.
• The benefit of chlorthalidone-based therapy on long-term total and CV mortality is most pronounced in hypertensive patients with diabetes.
50
40
40
30
20
15
13 13
10
10
4
5
0
Aksnes, T. A. et al. Hypertension 2007;50 2020/9/23
ALLHAT
Diabetes Incidence - 4 Years
(follow-up FBS 126 mg/dL for those <126 mg/dL at baseline)
2020/9/23
CVD Consequences
• Short and Long term • Antihypertensive Drug Related
2020/9/23
ALLHAT Incidence of Coronary heart disease by treatment group according to baseline diabetes
Systolic BP and CV Death in MRFIT
CV mortality rate per 10,000 person-years
250 225 200 175 150 125 100
75 50 25
0
Nondiabetic (n=342,815) Diabetic (n=5,163)
cause mortality, combined CHD, stroke, HF, all CVD, and ESRD
50
40
40
30
20
15 13 13 10
10
45
0
Wh.elton2,0P2.0K/9. /e2t3al. Arch Intern Med 2005;165:1401-1409.
<120 120-139140-159160-179180-199 200 Systolic BP (mmHg)
BP= blood pressure CV=cardiovascular MRFIT=Multiple Risk Factor Intervention Trial Sta2m02l0e/9r/2J3, et al. Diabetes Care. 1993;16:434-444.
20
15 13 13 10
10
Microv4asc5ular
endpoints
110120 130140150 160170 Mean SBP (mmHg)
0 5 6 7 8 9 10 11 Updated mean HbA1c concentration (%
Adler AI, et al. BMJ. 2000;321:412-419. Stratton IM, et al. BMJ. 2000;321:405-412. . 2020/9/23
Source # studies #subjects OR (95% CI)
All
11 109,052 0.96(0.91-1.01)
ACEI ARB
6
74,626 0.93(0.81-1.06)
5
34,426 0.93 (0.81-1.06)
HTN
7
86,414 0.99 (0.93--
1.06)
SHEP - 14 YEAR FOLLOW-UP
50
40
CV death (%)
40
30
PLACEBO
20
15 13 13
10
ACTIVE
10
45
0
2020/9/23
* = p< 0.05 vs no diabetes
CONCLUSIONS FROM SHEP +
• Chlorthalidone Rx of hypertension improves longterm outcomes.