中国心血管病调查.pptx

China Heart survey-Call for Action Dayi HuPeoples Hospital of Peking University2008-4-112The Primary Cause of Death:Cardio-Cerebral Vascular DiseasesStroke10%5.5mCAD 13%7.2mCancer 12%7.1mTrauma 9%5.2mInfection7%2.8mOther27%15.6mAIDS5%2.8mMalaria2%1.2mDiarrhea3%1.8mPerinatal factors4%2.5mCOPD 5%2.7mWorld Health Organization.Atlas of Heart Disease and Stroke.2005 3Major Risk Factors for CAD:Hypertension,Hyperlipidemia,HyperglycemiaAlthough the emergence of new drugs and the release of many evidence-based research outcomes recently,are the mortality of cardio-cerebral vascular events fully reduced?5Although the use of intervention therapy and drugs dramatically increased,the mortality of cardio-cerebral vascular diseases is still going upSource：Death and risk factors,epidemiology,trend and distribution in Chinese.Peking Union Medical College Press.Sep.2005.Standard Mortality（1/10 thousand）Mortality trend of cardio-cerebral vascular disease in Chinese between 1985 and 2005CADCerebral vascular disease6Cause：“The therapy is separated”7Cause：Hyperglycemia a neglected risk factor of CVDCVD Risk factorFamilyFamilyFatness Fatness SexSexDyslipidemiaDyslipidemiaHypertensionHypertensionAgeAgeHyperglycemia Hyperglycemia SmokeSmoke8China Heart Survey:ContentBackgroundDiabetes is as dangerous as CADPatients with CAD are at the high risk for hyperglycemiaDesignResultMeaning9Diabetes is as dangerous as CADHaffner SM et al.N Engl J Med.1998;339:229-234.Events/100 person-yrIncidence of cardiovascular disease during seven-year follow-up(%)n=6918.8Nondiabetic subjectswithout prior MINondiabetic subjectswith prior MIDiabetic subjectswithout prior MIDiabetic subjectswith prior MIn=1304n=169n=8903.00.57.83.23.545.020.2P0.001P 8 mmol/L in two testing17China Heart Survey:flow chartPreviously known diabetesNewly diagnosed diabetes（FPG）Newly diagnosed diabetes（FPG）773OGTT420Previously known diabetes411,234Acute admission2,279Elective admission3,513random3,687screened733561,490OGTTDa-Yi Hu,et al.European Heart Journal 2006;27:2573-2579.18China Heart Survey:contentBackgroundDiabetes is as dangerous as CADPatients with CAD are at the high risk for hyperglycemiaDesignResultMeaning19China Heart Survey：77%of patients with CAD had hyperglycemiaKnown diabetesNewly diagnosed diabetes(FPG)Normal glucosePrediabetesNewly diagnosed diabetes(OGTT)33%3%23%24%17%n=3,51320Without the use of OGTT,over 80%of newly diagnosed diabetes and pre-diabetes will remain undiagnosedNormal IFGIGTType 2 diabetes人群比例人群比例(%)OGTTOGTTFPGFPGAcuteSelective020406080100Percentage(%)missedmissed21ConclusionnIn the enrolled patients(n=3,513),the percentage of hyperglycemia(included diabetes and pre-diabetes)was about 80%The prevalence of diabetes was 52.92%(n=1,859)，of which 20.1%（n=706）was newly diagnosed diabetes The prevalence of pre-diabetes was 26.38%（n=927),all was newly diagnosed excepted one patient22If FPG was measured alone,without the use of OGTT80%of 609 newly diagnosed diabetic patients will remain undiagnosed70 of 926 newly diagnosed pre-diabetic patients will remain undiagnosed 75 of newly diagnosed diabetic and pre-diabetic patients will remain undiagnosed if FPG is measured alone.Conclusion23China Heart Survey:contentBackgroundDiabetes is as dangerous as CADPatients with CAD are at the high risk for hyperglycemiaDesignResultMeaning24China Heart Survey:meaningCHS sound the alert for our cardiologists,neurologists and cardio-vascular surgeons,indicating that we should concern whether dysglycaemia exist in the admitted patients.As far as dysglycaemia concerned,no matter what is diabetes,IFG or IGT,early diagnosis and early intervention help to reduce its harm to cardiovascular system.Therefore,the screening of dysglycaemia should be advocated.Cardiologist should prevent and treat diabetes in the first line.25