1 / 26

Prevention of hypertension, the most frequent cardiovascular disease .

Prevention of hypertension, the most frequent cardiovascular disease. prof. dr hab. med. Kalina Kawecka-Jaszcz, dr med. Piotr Jankowski I Department of Cardiology IK CMUJ Kraków. 14.10.2005 r. The most important causes of death in the world. tys. Ezzatti M. Lancet 2002; 360: 1347.

darren
Télécharger la présentation

Prevention of hypertension, the most frequent cardiovascular disease .

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Prevention of hypertension, the most frequent cardiovascular disease. prof. dr hab. med. Kalina Kawecka-Jaszcz, dr med. Piotr Jankowski I Department of Cardiology IK CMUJ Kraków 14.10.2005 r.

  2. The most important causes of death in the world tys. Ezzatti M. Lancet 2002; 360: 1347

  3. The risk of cardiovascular event according to the presence of hypertension. Kannel WB: JAMA 1996, 275, 1571.

  4. 2002 Hypertension in Poland 29 M 8.7 M 8.4 M Optimal BP Normal BP High normal BP Hypertension T.Zdrojewski NATPOL III PLUS 2002

  5. Hypertension in Czech Republic Cifkova R et al. J Hypertens 2004, 22, 1479

  6. Prevention of hypertension • Smoking. • Obesity. • Physical activity. • Diet: • salt intake, • alcohol intake, • fat intake, • fruits and vegetables.

  7. Men Women Prevention of HT - obesity BMI – BP relationship mmHg Systolic BP Diastolic BP * NS NS * * * NS * BMI BMI Sharabi Y i wsp. Am J Hypertens 2004; 17: 404

  8. Prevention of HT - obesity The influence of weight reduction on the frequency of drug prescription tygodnie Whelton PK: JAMA 1998;279:839

  9. Prevention of HT - obesity BMI < 25 kg/m2 Waist < 88 cm (W) < 102 cm (M) AHA 2004

  10. Prevention of HT – physical activity 13/10mmHgFentern, Br Med. Bull 1992, 48, 630. 5-7/5-7 mmHgArroll, J Clin Epidemiol 1992, 45, 439. 6/7 mmHg (HT borderline) Fagard, J Cardiovasc Pharmacol 1995, 25-I, S20. 10/8 mmHg (HT moderate) Fagard, J Cardiovasc Pharmacol 1995, 25-I, S20. 4 – 9 mmHgESH/ESC 2003, JNC VII. The influence of regular physical activity on BP:

  11. Prevention of HT – physical activity The influence of regular physical activity on BPMeta-analysis of randomized trials 54 trials 2419 participants Mean reduction in systolic blood pressure: 4,94 mmHg diastolic blood pressure: 3,73 mmHg Reduction of BP [mmHg] Whelton SP et al.: Ann Intern Med. 2002; 136:493.

  12. Prevention of HT – physical activity Aerobic physical 30 – 45 min 4-7/week activity* Vigorous-intensity ** 20-40 min 3-5/week Moderate-intensity ** 30 min 4-7/week * - JNC VII, PTNT 2003 ** - AHA 2002

  13. Prevention of HT– salt intake Reduction in salt intake by 6 g daily (100 mmol Na+) BP reduction by about 4 - 6 mmHg ESH/ESC 2003

  14. Prevention of HT– salt intake The influence of salt intake reduction (by 40 mmol/d) on the risk of hypertension development by 14 % Observation: 36-48 months Kumanyika et al. J Hum hypertens 2005, 19, 33.

  15. EPOGH Prevention of HT– salt intake 24-hour urinary sodium excretion mmol/24h Stolarz K i wsp. Hypertension 2004;44:156.

  16. Prevention of HT– salt intake The influence of salt intake reduction on the frequency of drug prescription weeks Whelton PK: JAMA 1998;279:839

  17. Prevention of HT– salt intake Sodium intake should be perceived as the significant environmental factor, which influences not only blood pressure, but also: • left ventricular mass • arterial stiffness • sympathetic nervous activity Sodium intake was observed to be a strong modulator of the impact of the genetic factors on many of the cardiovascular phenotypes.

  18. EPOGH Ambulatory blood pressure (ABPM) and β-adducin (ADD2) C1797T polymorphism NS P=0.03 P=0.01 24-h systolic BP, mmHg 24-h Na, mmol/d P=0.01 CC T CC T CC T CC T Slavic Italian Slavic Italian β-adducinC1797T polymorphism influences urinary sodium excretion (decreased in the presence of T allele). It is also related to systolic blood pressure, but only in the populations with high sodium intake. Tikhonoff et al. Am J Hypertens. 2003;16:840.

  19. Prevention of HT– alcohol intake Pressure threshold: men: 20-30 g ethanol/d women: 10-20 g ethanol/d Consumption ≥ 3 drinks daily BP increase of 3-4/1-2 mmHg

  20. Relationship of alcohol drinking pattern to risk of hypertension N = 2609 Stranges et al. Hypertension 2004;44:813

  21. Prevention of HT– alcohol intake The influence of small amounts of alcohol on the effectiveness of the DASH diet. BP reduction [mmHg] Ann Intern Med. 1999;159:225

  22. Prevention of HT– alcohol intake In 2002: The average ethanol intake in Poland: 5.87 l/year About 4 M intemperates About 600-900 thousands dependents About 25 %increase in alcohol intake fromthe time of excise reduction in 2002. PARPA i SPBS

  23. Prevention of hypertension The influence of non-pharmacological interventions – randomized trials Kastarinen MJ. Hypertens 2002;20:2505 Mattila R. J Hum Hypertens 2003;17:199 Jankowski P, Kawecka-Jaszcz K. Nadciś Tęt 2001;8 (supl. D): 25.

  24. Prevention of HT– real life The proportions of patients advised about lifestyle in Slovenia Accetto R: Blood Press 2005; 14 (suppl 2): 22.

  25. Prevention of HT– real life The proportions of hypertensives advised about lifestyle in Poland NATPOLPLUS 2002

  26. Contraceptives pills and BP Pills Controls N = 94 BP > 140/90 mmHg in 5 % of users after 5 years Narkiewicz K i wsp. Am J Hypertens 1995, 8: 249

More Related