《生活方式和健康》PPT课件.ppt

生活方式和心血管健康 赵冬 首都医科大学附属北京安贞医院 北京心肺血管疾病研究所 人类经历了几十万年的发展 才走到今天,而每个个体的生命至 多只有百年。如果按目前中国人 平均期望寿命计算，每个人从出 生开始拥有生命的总天数是26645 天。 生活方式50% 医疗服务10% Other CVD 健康的决定因素 个体遗传20% 环境因素20% 康 环 境 健 健康生命的基健康生命的基 本要素本要素 其他脏器 心脏 肾脏 肺脏 脑 肝脏 血 管 饮食 运动心理健康 不嗜酒 不吸烟 血压 血脂血糖 体重/腰围 健康生活方式要素 大多数时间心情舒畅 建立健康饮食习惯 建立规律体力活动的习惯 不吸烟，不嗜酒 尽量远离不健康的生活环境 如何做到在大多数时间心情舒畅？ 学会从乐观和善意的角度看待问题 在珍爱亲人的同时珍爱自己 学会宽容 学会交流的方式 把心情舒畅和减少过度的心理压力作为自己 重要的生活能力 什么是健康饮食习惯的标准？ 吃什么？ 吃多少？ 怎么吃？ 吃什么? 碳水化合物类 （主要是粮食） 蛋白质类（肉类、蛋、奶、植物蛋白） 脂肪类（肥肉、各种烹调油） 无机盐类（钠、钾、钙、镁、铁等） 维生素 水 Chinese Dietary Pagoda-2007.12 Chinese Nutrition Society, Ministry of Health of China, Chinese Dietary Guidelines,1997 Exercise 6000-step walk Oil 2530 gram Salt 6 gram Milk /milk products 300 gram Soybeans and nut 3050gram Shrimp and fish 50100 gram Meat and poultry 5075 gram Eggs 2550 gram Fruit 200400 gram Vegetable 300500 gram Grain, batata and peas 250400 gram Water 1200 ml 盐=140,或舒张压=90mmHg 如果已经有高血压或偏高的血压怎么办？ 血脂和血脂异常血脂和血脂异常 血糖和血糖异常血糖和血糖异常 正常血糖: 空腹：=7mmol/L (126mg/dl) 餐后两小时：11.1mmol/L (200mg/dl) 如果发现血糖高或已有糖尿病怎么办？ 饮食和高血压关系的研究介绍饮食和高血压关系的研究介绍 Global Burden of Hypertension Global Burden of Hypertension in Adult Population in 2000 and 2025 in Adult Population in 2000 and 2025 (%) Patricia M Kearney Lancet 2005 365:217-23 The estimated total number of adults with hypertension in the worldwide 2000 2025 972 million 1.56 billion Estimated Costs for Hypertension TreatmentEstimated Costs for Hypertension Treatment in the Worldwidein the Worldwide If anti-hypertension drug would cost If anti-hypertension drug would cost $ 1 /day $ 1 /day on average:on average: Then:Then: 2000 2000 20252025 $ 972 million/ day $ 972 million/ day $1.65 billion/day$1.65 billion/day $ 354.8 billion/ year $ 354.8 billion/ year $602.3 billion/year$602.3 billion/year Jin Ling Tang BMJ 2005 330:610-1 Can we prevent or delay the development of hypertension ? Or We only treat the hypertension after it occur? Established Risk factors for Hypertension Established Risk factors for Hypertension Diet:Diet: Race Race High sodium High sodium Genetic factors Genetic factors Low potassium Low potassium Age Age Omega-3 polyunsaturated fat Omega-3 polyunsaturated fat Dietary patterns Dietary patterns Overweight and obesityOverweight and obesity AlcoholAlcohol Lack of physical activity Lack of physical activity StressStress SmokingSmoking Sleep disordersSleep disorders Modified Risk Factors Unmodified Risk Factors The Changes of Daily Consumption of Salt in The Changes of Daily Consumption of Salt in Urban and Rural Areas of China from 1982 to 2002 Urban and Rural Areas of China from 1982 to 2002 (g/day/person) Report of China National Nutrition and Health Status Survey. 2002 6% 4.4% China national dietary guideline: daily salt consumption: 6g/day The Changes of Daily Consumption of Fruits in The Changes of Daily Consumption of Fruits in Urban and Rural Areas of China from 1982 to 2002 Urban and Rural Areas of China from 1982 to 2002 (g/day/person) Report of China National Nutrition and Health Status Survey. 2002 46% 2% China national dietary guideline: daily fruit consumption: 150g/day Hypertension in ChinaHypertension in China (Fourth National Survey of Nutrition and Health Status in China) 200 millions 15%15% Prevalence rates Men Women (million) Wang Longde. Report of National Survey of Nutrition and Health Status 2002 100 millions 20%20% 13%13% 18%18% Numbers of hypertension New New Hypertension Patients in China by TimeHypertension Patients in China by Time Based on Increased Rate from 1991 to 2002 Based on Increased Rate from 1991 to 2002 5 454 545/Year 454 545/Month 15 151/Day 631/Hour 11/minite 1/5 seconds The relationship between salt and blood pressure were studied In 10079 men and women aged 20-59 sampled from 52 centres around world. Sodium excretion ranged from 0.2mmol/20 h (Brazil) to 242 mmol/24 h (China) Intersalt cooperation research group BMJ, 1988 297:319- 28 Intersalt cooperation research group BMJ, 1988 297:319- 28 FJ He J Human Hypertension 2002;16:761-770 Hypertensive Median 24 urinary sodium reduced from 9.5g to 5.1g SBP net change : -4.96 0.40mmHg (95%CI: -5.75 to -4.17) Normotensive Median 24 urinary sodium reduced from 9.1g/day to 4.8g/day SBP net change : -2.030.27mmHg (95%CI: -2.56 to -1.56) Observational study Well designed RCT Meta analysis FJ He J Human Hypertension 2002;16:761-770 Additional potassium intake: median 75 mmol /day in a median duration of 5 weeks. SBP net change : -4.85mmHg (95%CI: -6.95 to -2.74) in 28 trials no antihypertensive drug. DBP net change : -2.71mmHg (95%CI: -4.61 to -0.83) in 28 trials no antihypertensive drug. Observational study Well designed RCT Meta analysis Johanna Geleijnse J of Hypertension 2002; 20: 1493-1499 Observational study Well designed RCT Meta analysis Johanna Geleijnse J of Hypertension 2002; 20: 1493-1499 Frank M. Sacks The New Eng J of Med 344: 3-10 Observational study Well designed RCT Meta analysis Frank M. Sacks The New Eng J of Med 344: 3-10 Frank M. Sacks The New Eng J of Med 344: 3-10 Lawrence J Appel JAMA