临床实践 对年龄>50岁的患者,收缩压作为心血管危险 因素比舒张压更加重要 血压从11575mmHg开始每升高2010mmHg, 心血管危险翻一番 Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903-13 55岁的正常血压者在此后25年内90%发展成高 血压 Vasan rS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in women and men: The Framingham Heart Study. JAMA. 287: 1003-1010
▪ 对年龄>50岁的患者，收缩压作为心血管危险 因素比舒张压更加重要 ▪ 血压从 115/75 mmHg开始, 每升高20/10 mmHg， 心血管危险翻一 番 ▪ 55岁的正常血压者在此后25年内90%发展成高 血压 临床实践 Prospective Studies Collaboration。Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies。Lancet 2002; 360: 1903–13 Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in women and men: The Framingham Heart Study. JAMA. 287:1003-1010
Blood pressure cardiac output x total vascular resistance
Risk Factors for Hypertension Genetic Race Diabetes Dyslipidemia Lack of xercise obese Alcohol Stress(?)
Risk Factors for Hypertension Dyslipidemi a Race Genetic Diabetes Lack of exercise Alcohol Stress (?) obese
Paihophysioloyisll Aspsyiy oi Primry hypertension ◆ Salt and the kidney o Sympathetic nervous system O Renin-Angiotensin-Aldosterone System o Hemodynamics and structural changes ◆ Endothelial factors
The Kidney and Hypertension e Transplantation of a kidney from a genetical model of human hypertension, e. g. SHR rats, results in hypertension in the normotensive recipient animal o Clinical studies in human renal transplant patients also indicate that the genetic background of the kidney donor with respect to predisposition for genetic hypertension significantly influences BP andor the need for antihypertensive medication in the recipients o without an abnormality in the kidney elevated blood pressure could never be maintained because of pressure induced diuresis