血压分类中国2004 收缩压 舒张压 (mmHg) (mmHg) 正常血压 <120 <80 正常高值血压 120-139 80-89 I级高血压(轻度) 140-159 90-99 Ⅱ级高血压(中度) 160-179 100-109 Ⅲ级高血压(重度) ≥180 ≥110 单纯收缩期高血压 ≥140 <90 非同日反复血压测量
血压分类—中国 2004 收缩压 ( mmHg ) 舒张压 ( mmHg ) 正常血压 < 120 < 80 正常高值血压 120-139 80-89 I 级高血压(轻度) 140-159 90-99 II级高血压(中度) 160-179 100-109 III级高血压(重度) 180 110 单纯收缩期高血压 140 < 90 非同日反复血压测量
JNC7和ESH/ESC指南 不同血压测量方式的高血压诊断标准 收缩压 舒张压 诊所血压测量 140 90 24小时动态血压 125 80 家庭自测血压 135 85 对所有的人规定一个固定的数值为“高血压”并非最佳概念。应在 评估每个患者其总体心血管危险的基础上,灵活地确定该患者的血压水 平处于正常或高血压
不同血压测量方式的高血压诊断标准 收缩压 舒张压 诊所血压测量 140 90 24小时动态血压 125 80 家庭自测血压 135 85 对所有的人规定一个固定的数值为“高血压”并非最佳概念。应在 评估每个患者其总体心血管危险的基础上,灵活地确定该患者的血压水 平处于正常或高血压 JNC 7 和ESH /ESC 指南
临床实践 不同血压参数预测心血管死亡的价值 Prospective Studies Collaboration, meta-analysis Blood pressure index Informativeness for prediction of Stroke IHD Systolic blood pressure(SBP 89% 93% Diastolic blood pressure(DBP 83 73% Pulse pressure(SBP-DBP 37% 43% Mean arterial pressure(2 /3DBP+1/3SBP 100 97% Mid blood pressure(1/2SBP-+1/2DBP 100% 100 61个前瞻性临床试验,958074例受试者,40-89岁,随访127万病人年,血管性死亡 56000例(脑卒中12000,冠心病34000,其它10000),其它死亡6600例 Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortal ity: a meta-analysis of individual data for one million adults in 61 prospectivestudies e Lancet 2002; 360: 1903-13
不同血压参数预测心血管死亡的价值 Prospective Studies Collaboration,meta-analysis 61个前瞻性临床试验,958074例受试者,40-89岁,随访127万病人年,血管性死亡 56000例(脑卒中12000,冠心病34000,其它10000),其它死亡66000例。 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 临床实践
临床实践 A: Systolic blood pressure B: Diastolic blood pressure A: Systolic blood pressure B: Diastolic blood pressure Age at risk 019 6069 59 603 4049 Usual systolic blood Usual diastolic blood Usual systolic blood Usual diastolic blod pressure(mm pressue(mr地g pressure imm Hg 年龄,血压与脑卒中死亡 年龄,血压与冠心病死亡 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
临床实践 年龄,血压与脑卒中死亡 年龄,血压与冠心病死亡 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
Lifetime risk of developing Hypertension Beginning at Age 55 100 80 Men Wome g60 940 620 0 02468101214161820 Residual lifetime risk of developing Years hypertension among people with blood pressure <140/90 mmHg Vasan Rs,eta.JAMA.2002;287:1003-1010
0 2 0 4 0 6 0 8 0 100 0 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0 Risk of hypertension (%) Residual lifetime risk of developing hypertension among people with blood pressure <140/90 mmHg Years Lifetime Risk of Developing Hypertension Beginning at Age 55 Men Wome n Vasan RS, et al. JAMA. 2002; 287:1003-1010