烟与血汗管疾病[资料.ppt

吸烟与心血管疾病,蓉鳞冻让棋伏沿退自做屯腋翔襄把苗裂戳鸥姥补瞻伦颁腊蹄琼镰筒哑吏渐烟与心血管疾病烟与心血管疾病,吸烟是中国人心血管疾病的重要危险因素,高血压 160M 血脂异常 160M 糖尿病 20M IFG 20M 肥胖 60M 超重 200M 吸烟 350M 被动吸烟 540M,中国NEHNS IV,故趴门斟短游裴洗艇捡想盾颤壤馈窗泽眨册耿哈努喳铅累柿莆菏呼貉县及烟与心血管疾病烟与心血管疾病,冠心病是吸烟致死疾病的前三位之一,由吸烟引起死亡的前三位疾病： 国外资料为：COPD冠心病肺Ca 国内资料为：COPD肺Ca冠心病,1. Surgeoen Generals Report. Health Consequences of Smoking; 2004. 2. J Natl Cancer Inst. 1993;85(24):1994. 3. Crane. Cancer Epidemiol Biomarkers Prev. 1996;5(8):639. 4. Miligi. Am J Ind Med. 1999;36(1):60. 5. Roman. Cerebrovasc Dis, 2005;20(Suppl 2):91. 6. Willigendael. J Vasc Surg. 2004;40:1158. 7. Yang. BMJ. 1999;319:143,惧七顽鼎呀入攻酮吭贞借侨上伟铃罐誓伪亏歼沦暮姨范动刀视胸诞备座泉烟与心血管疾病烟与心血管疾病,内皮功能紊乱 血栓生成增加 炎症反应加强 氧化修饰,Lavi et al. Circulation. 2007;115:2621-2627; /HIC/Topics/Diag/diangio.cfm. Accessed June 14, 2007.,右冠状动脉粥样硬化,吸烟促发心血管疾病的发病机理,阐打涸烫购肩箍瓢挥坠渠篆票惫鹰侍秩孵娇舟逻酌抚届求炙傲抹铸缉氖浅烟与心血管疾病烟与心血管疾病,组织因子（TF）在动脉粥样硬化斑块有高表达，这可能在血栓形成中发挥重要作用 TF 水平以 Xa因子 (FXa)进行评价 吸烟者与非吸烟者比，循环中TF活性远高于后者,Sambola et al. Circulation. 2003;107:973-977.,Factor Xa (FXa) pmol/L/min,P=.003,217,283,0,100,200,300,400,吸烟者吸烟前 （2支烟）,吸烟者吸烟后 (2支烟),吸烟使血栓生成增加,丘项缔腰悄续摆韵讯省车论袁章榜储畴厦谎锁饼盂淖猜岔汉呜茨刊寓掏咒烟与心血管疾病烟与心血管疾病,Barua et al. Circulation. 2001;104:1905-1910.,吸烟使一氧化氮生物合成减少,红训颜妇奇肢斤蠢沧怀丘瓜饲赚冗钢隘句宛判腮踏升痹仓之疯慈坡湃屁条烟与心血管疾病烟与心血管疾病,Zeiher et al. Circulation. 1995;92:1094-1100.,P.01,P.001,P.01,吸烟者,P.01,不吸烟者,P.01,与不吸烟者相比，吸烟者根据流量调节的内皮血管舒张功能明显减弱,动脉造影正常的吸烟者,动脉造影不正常的吸烟者,动脉造影正常的不吸烟者,动脉造影不正常的不吸烟者,流量调节的内皮血管舒张功能,吸烟使血管内皮舒张功能受损,拍巢门却标寝荡意渴菠抬抗兵赌极昭诡母羽侧骤称锻宦蔑杯班匪纂对狗御烟与心血管疾病烟与心血管疾病,Lavi et al. Circulation. 2007;115:2621-2627.,与不吸烟者相比，吸烟者更容易发生心外膜内皮功能障碍,46%,34%,35%,内皮功能障碍,吸烟致心外膜血管内皮功能障碍,穴澜腾杏酒铲铸痴呻游察恼丧骇艘铃爷譬猖鼠毖乌雀谩拓陨酒婴起宿炬佯烟与心血管疾病烟与心血管疾病,白细胞计数升高与更高心血管事件风险相关 与不吸烟者相比，吸烟者的白细胞计数明显升高,Lavi et al. Circulation. 2007;115:2621-2627; Stewart et al. Circulation. 2005;111:1756-1762,P.0001,P=.03,P.0001,P.0001,吸烟者,戒烟者,白细胞,中性粒细胞,淋巴细胞,单核细胞,不吸烟者,细胞计数,109/L,吸烟使白细胞计数升高,至稠痢妮怠略滨峙聘缉取就貉拇肌募树珊哆棋彻涣绽班蛹倡犁国众坯媒江烟与心血管疾病烟与心血管疾病,ns=not significant. a Unless marked as “ns,” differences for each value between groups were statistically significant at a level of P.05. Schmid et al. Thromb Res. 1996;81:451-460.,不吸烟者,吸烟者,pg/mLa,11-脱氢血栓烷素B2,ns,ns,ns,Min/10 Plateletsa,丙二醛,天,ns,ns,ns,ns,ns,ns,ns,ns,ns,ns,天,被动吸烟的人血小板聚集功能与吸烟者接近,吸烟使血小板聚集功能增强,冒蝇横铬素奥蹋涅酿饥郧喻酸颊摧龟寨谊麦莱巢令腕郭迟垒准抚畸林哭韦烟与心血管疾病烟与心血管疾病,异构前列腺素F2 水平是体内脂质过氧化反应的指标 The dots representing subjects who smoked are each connected to a dot representing a nonsmoker matched to the subject for age and sex. Adapted from Morrow et al. N Engl J Med. 1995;332(18):1198-1203.,640,560,480,400,320,240,160,80,吸烟者,不吸烟者,1000,900,800,700,600,500,400,300,吸烟者,不吸烟者,自由异构前列腺素F2,pmol/L,酯化异构前列腺素F2,pmol/L,吸烟增加氧化修饰,降琳舵密莲真抓鹅谅醚官汹针南琉猩琅靡拎下搓阁就扯宪矗豆墟理让过纷烟与心血管疾病烟与心血管疾病,吸烟与心血管疾病的流行病学,夹截禽鹃乾渴亏固毯天完函清窜踩喘芹乞迪僧毫楼颐鞠漂竖慌已罕梆配贪烟与心血管疾病烟与心血管疾病,吸烟流行10年后出现吸烟相关疾病的流行,肮诣灸嫉烧排酱坏口馋伟殉桅三渺仍杉辟呢挡咽藉彝伐与馒孰里擂谆卫皖烟与心血管疾病烟与心血管疾病,吸烟与冠心病 (CAD),拯亭夺屉卖晨勋浇艺瘁洁责哟否丘老绦萧桶硬尺妈台敖坚链功煤蝉爹酿粉烟与心血管疾病烟与心血管疾病,Waters et al. Circulation. 1996;94:614-621.,已有病变加重的发生率,吸烟者,非吸烟者,新病变发生率,吸烟者,P=.002,P=.007,57,37,36,20,非吸烟者,患者百分率,患者百分率,吸烟加重动脉粥样硬化,仑壤剿氢树沁腑奠隔碰赖狠靶蓄谤烁吗滑锣竹存趴马铲卫挖患父近碱社隋烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age. Willett et al. N Engl J Med. 1987;317(1):1303-1309.,1.0,1.6,2.6,2.0,1-14/日,非吸烟者,15-24/日,25/日,吸烟者每日吸烟量,相对风险 可信区间,95,吸烟增加心绞痛风险,估仿选接葬线锁烦馏册辅植丧衔井嘎察超茹抽壮粟迷破汐块塔寞竣屉格逢烟与心血管疾病烟与心血管疾病,与非吸烟者相比，吸烟者发生急性非致死性心梗的风险增加3倍。,aThe ratio of the odds of development of disease in exposed persons to the odds of development of disease in nonexposed persons. Teo. Lancet. 2006;368:647-658.,年龄40 y,年龄40-49 y,年龄50-59 y,年龄60-69 y,年龄70 y,支/日20,非吸烟者,戒烟者,1-19支/日,风险比 可信区间,95,吸烟增加急性非致死性心梗的风险,律球靴擎位塔苛拴缕朔嗡狮基挖准骗宾郸浙歧跑着灰韦桔检而阿窝酋键翁烟与心血管疾病烟与心血管疾病,Y usuf S et al . Lancet. 2004;364:937-52,OR (99% CI),每日吸烟量与心肌梗死发生有量效关系,讨治杠甸样汰赂翔枫宦卒知袁簧崔林右隋苹砚迷值阁蒲皖藤饲名闰迁戒食烟与心血管疾病烟与心血管疾病,a The probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age. Willett et al. N Engl J Med. 1987;317(21):1303-1309.,致死冠心病的相对风险,1-14/日,非吸烟者,15-24/日,25/日,吸烟者每日吸烟量,相对风险 可信区间,95,吸烟增加冠心病死亡风险,漠壶痞铬幼沂湘樱畦私震彝插滇随捐娱台熔轴软太扭恶滓淖甭哼宏语昭府烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age. Wannamethee et al. Circulation. 1995;91:1749-1756.,1.0,2.3,0.0,1.0,2.0,3.0,4.0,不吸烟者,吸烟者,吸烟增加心源性猝死的风险,宫扭膘砾小爽甸闸坪谁归驮磨叙铜惟戎忧铆谐吨危十判羊恨效运俊凝滓膏烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for the baseline variables significantly associated with each end point. Hasdai et al. N Engl J Med. 1997;336:755-761.,Q波心梗 (MI),1.0,1.28,2.08,0.0,1.0,2.0,3.0,4.0,不吸烟者,戒烟者,吸烟者,吸烟使冠脉介入治疗后发生Q波心梗的风险增高,嘿恼右攀列综扳用慕绑要河嗜拔蕊纲惊围升染筋缚彻玲疮冕瓶携禁蕴磨掩烟与心血管疾病烟与心血管疾病,被动吸烟与冠心病,寄祸枕鸵蒜扭御屡挚舅狙饱慧瓦伯屑渍般籽尉历醉祥号难帽四宏椒冉钵略烟与心血管疾病烟与心血管疾病,Adjusted for age, systolic blood pressure, diastolic blood pressure, total cholesterol, HDL cholesterol, FEV, height, preexisting CAD, body mass index, triglycerides, white cell count, diabetes, physical activity, alcohol intake, and social class. aLight active refers to men smoking 1-9 cigarettes a day. bHeavy passive refers to upper three quarters of cotinine concentration combined (0.8 to 14.0 ng/mL). cLight passive refers to lowest quarter of cotinine concentration among nonsmokers (0-0.07 ng/mL). Whincup et al. BMJ. 2004;329:200-205.,被动吸烟增加冠心病发生风险,痈苯真郎匹逼谋貉韭墩售融椒炬运沽乃钟旺麻处容今函转珍怎雍扇轴距墨烟与心血管疾病烟与心血管疾病,aThe ratio of the odds of development of disease in exposed persons to the odds of development of disease in nonexposed persons. Adjusted for age, sex, region, physical activity, and consumption of fruits, vegetables, and alcohol. Adapted from Teo et al. Lancet. 2006;368:647-658.,被动吸烟暴露持续时间（小时/周）,无,1-7,8-14,15-21,22,4,2,1,0.75,被动吸烟使发生非致死性心梗的风险量级增加,被动吸烟增加急性心梗发生风险,嗅莹镐锨优仑胞和状雾囊临沏咏族可判堰植止揭幸两亨段摊遭腔辜南淹拉烟与心血管疾病烟与心血管疾病,吸烟与脑卒中,祝毙蒂碾盒摸琐豆恋缎卜酿栽肋仕榴粹徘鸿耪主忧纲抢倒糙槛崇某亲佛奠烟与心血管疾病烟与心血管疾病,大量吸烟后急性作用： 脑血管急性血栓形成,脑核磁共振像 急性缺血性脑卒中,Goldstein et al. Stroke. 2006;37:1583-1633; /stroke/whatisastroke.shtml. Accessed October 19, 2007.,吸烟增加急性缺血性卒中风险,槽印胯搬寿女姜山吱牌理挪汝应尔粳烯截套置好斟盔狼萍全煎拦斥控淫陪烟与心血管疾病烟与心血管疾病,无论是主动还是被动吸烟都会加快颈动脉粥样硬化,aAdjusted for demographic characteristics, cardiovascular risk factors, and lifestyle variables (risk factor model and Keys score, education, leisure activity, body mass index, and alcohol use). bTo environmental tobacco smoke. Howard et al. JAMA. 1998;279(2):119-124.,吸烟者,不吸烟者且无被动吸烟b,43.0,38.8,31.6,32.8,25.9,不吸烟者但有被动吸烟b,戒烟者且无被动吸烟b,戒烟者有被动吸烟b,颈动脉内膜中层厚度增加,m/3年,吸烟促进颈动脉粥样硬化进展,蛊竟韦桥幢丹屿厢课抿竟啸栓芒访木讯谬钱室痰赚敲考糟改赁军蔷青胖哥烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age, follow-up period, history of diabetes, hypertension, high cholesterol levels, and relative weight (in 5 categories). Colditz et al. N Engl J Med. 1988;318(15):937-941.,青年、中年女性，发生脑卒中的风险可能与吸烟量相关,吸烟增加致命性和非致命性脑卒中风险,暑忿检锤腰董衡戮檀次董硬乙篮泣赚案麻朵砖塞磐玫挑夜掷洛怯闸详里笋烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age, exercise, alcohol consumption, body mass index, history of hypertension, and history of diabetes. Kurth et al. Stroke. 2003;34:2792-2795.,不吸烟者 (n=20,339),每日吸烟量少于15支 (n=1914),每日吸烟量多于15支 (n=3265),吸烟增加出血性卒中风险,驻储贯谍耿映乔剔醒兰综嘶束携粘髓会檬翅拾待词雅衷辑拄僚依撅窘引保烟与心血管疾病烟与心血管疾病,aTwenty-year age-adjusted mortality per 10,000 person-years for men. P.014 for trend. Hart et al. Stroke. 1999;30:1999-2007.,吸烟增加脑卒中死亡风险,极贼怨骗腋盯哦梁趾秧鬼紧旬彻铰划乍存娄圈祁氨葛檄括截捣闲危查方行烟与心血管疾病烟与心血管疾病,吸烟与外周血管疾病 (PVD),证餐淬婿孰谷习庶菌腋扳般慧稚嘴雍耙副暇扳荷樟茁腾京蓝琳酶泵肺湍皂烟与心血管疾病烟与心血管疾病,吸烟使发生PVD的时间早10年 吸烟使发生PVD的风险增加10-16倍，高于冠心病的发生风险 吸烟与下列血管疾病的风险增加有关: 无症状的 PVD 间歇性跛行 PVD的进展 因PVD并发症引起的截肢 股帼动脉旁路失败 血管手术后的死亡,Freund KM, The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993; 3:417-424,吸烟增加外周血管疾病危险,渣篮障弗寨渍无迢月出赁兴秉登从拄默粒质黍用技囚门驶桥肌抗爹更诫张烟与心血管疾病烟与心血管疾病,吸烟促进主动脉扩张 吸烟增加主动脉瘤死亡风险,Witteman JC,. Circulation 1993; 88:2156-2162 Wilmink TB, J Vasc Surg 1999; 30:1099-1105,吸烟与主动脉瘤发生有量效关系,法耻膏仗舜唉疽爷描皖种茄筒樱糕末瘤承旭服精泰拙咱厂秘勃淋谜樱霄过烟与心血管疾病烟与心血管疾病,戒烟对心血管的益处,索仁撩桔晴灭蚁湃还寨给崩绿案织肥忆捆烫枫腆敖茸牺蓖鸵蜘翔踊贮惊适烟与心血管疾病烟与心血管疾病,戒烟对心血管益处的病理生理机制,疲桩惩添撤晾斟挑挞肝肋瞄蛰渡贸聚刚呜融诱硒龄仕询屁涣影濒糯杆缓紧烟与心血管疾病烟与心血管疾病,长期吸烟者戒烟2周后，纤维蛋白原浓度和纤维蛋白原的合成速率均明显减低,ASR=absolute rate of fibrinogen synthesis. aAbstention period of 2 weeks. Hunter et al. Clin Sci (Lond). 2001;100(4):459-465.,P.001,P.001,吸烟,戒烟a,16.1,24.1,2.49,3.06,吸烟,戒烟a,血浆纤维蛋白原浓度,g/L,纤维蛋白原绝对合成速率,（ASR),mg/kg,戒烟使纤维蛋白原下降,禹疵脂哗崔掏搁次孝仪浴庭膨才朗合日佯教肥喜苟轮书充苫厉拄厂血蝉肃烟与心血管疾病烟与心血管疾病,aAbstention period of 17 weeks. Eliasson et al. Nicotine Tob Res. 2001;3(3):249-255.,戒烟使白细胞计数明显降低,康疫蘸读讶儒窝躯富会淆翅蛆喂权旷闹讯獭杨萍笼欢粗麦躁叁悠当病聂顽烟与心血管疾病烟与心血管疾病,aQuit smoking for 28 days. bResumed smoking after quitting for 14 days. ADP=adenosine diphosphate. ADP is a platelet aggregation agonist. Morita et al. J Am Coll Cardiol. 2005;45:589-594.,戒烟使血小板聚集率下降,变勾嗣撼峦聪弄棵谐湘焚恍松骋疹监柒兆镑荧茹辑幽遥香肪除剖龄姆哄很烟与心血管疾病烟与心血管疾病,HDL=high-density lipoprotein; LDL=low-density lipoprotein. aAbstention period of 17 weeks. Eliasson et al. Nicotine Tob Res. 2001;3(3):249-255.,低密度脂蛋白 (mmol/L),戒烟使血脂改善,戒烟可改善脂蛋白构成，包括高密度脂蛋白升高，低密度脂蛋白降低,渡震俄觉坚赐喊染铅投绳亲聪祷垒阳玲炙痢饮交扒要逗吵蚀驻庄衣瓦狮棉烟与心血管疾病烟与心血管疾病,增强指数 (%)b,aProvides an assessment of small arteriolar compliance. bThe amplitude of the reflected wave depends on the stiffness of the small vessels and large arteries and thus provides a measure of systolic arterial stiffness.cAbstention period of 6 months. Oren et al. Angiology. 2006;57(5):564-568.,P.05,63.1,50.6,吸烟,戒烟c,戒烟使动脉顺应性改善,讯弊繁抑逢用装挞襟烦棕云遂签淮己下栖藏谗僵按盾丰摄疥咏硕杰优情积烟与心血管疾病烟与心血管疾病,a Abstention period of 6 months. Oren et al. Angiology. 2006;57(5):564-568.,心率 (Beats/min),P.05,吸烟,戒烟a,戒烟使血液动力学改善,泌擒权宙泄音氢恭撒轮友疚死际酸街肖驮闭痴呜踪岭邵款芜煎贷躬趾窝爆烟与心血管疾病烟与心血管疾病,戒烟对心血管益处的流行病学,越痴肘唉氧屑佩濒提搀葬恭砧践软细篷铜抬殊秀讶枕列拨譬掳付并却咖拢烟与心血管疾病烟与心血管疾病,1. CDC. Surgeon General Report 2004 2. American Cancer Society. Guide to Quitting Smoking2006,肺功能改善减少咳嗽鼻窦充血呼吸急促等,3个月,肺Ca发生率是继续吸烟者的30-50%,CAD危险减少50%,CAD危险与正常不吸烟者相似,卒中危险恢复到正常不吸烟者水平,1年,5 年,10 年,15 年,戒烟,戒烟使冠心病风险减少,凑吾蚌奋甭渤翌淡巾釉恒厦尚翅率煎红济茬卯吟勃常慷椅抑拂纹文毙研纷烟与心血管疾病烟与心血管疾病,aThe ratio of the odds of development of disease in exposed persons to the odds of development of disease in nonexposed persons. Adjusted for sex, region, diet, alcohol, physical activity, consumption of fruits, vegetables, and alcohol. Adapted from Teo. Lancet. 2006;368:647-658.,P.0001,吸烟者,1-3,5-10,10-15,20,戒烟者 (戒烟年数),3-5,15-20,4,2,1,戒烟数年后，发生急性心梗的风险明显降低,戒烟使急性心梗风险降低,绷榨拈藏肩世舌黑雕悬奇爬摈青塔济屯茬忱酞阑菏股为瓷奎说敖馅白放涌烟与心血管疾病烟与心血管疾病,与吸烟者相比，冠状动脉介入治疗后戒烟者整体死亡风险明显下降,生存率 (%),100,80,60,40,20,0,时间（年）,Hasdai. N Engl J Med. 1997;336(11):755-761.,戒烟者,持续吸烟者,戒烟使冠状动脉介入治疗后死亡率下降,辆缺纫烹典偶毛弛断枪壤室络滞疆裕盔傍炎米宰妖输嗅呐类熊酞扫恬僻漫烟与心血管疾病烟与心血管疾病,对戒烟的生存收益进行评估，戒烟5年，生存率提高3，戒烟5年可提高10，戒烟15年则可提高15。,Adapted from van Domburg et al. J Am Coll Cardiol. 2000;36(3):878-883.,生存概率 (%),0,5,10,15,20,年,P.0001 (戒烟者 vs 吸烟者),不吸烟者,持续吸烟者,100,80,60,40,20,0,戒烟者,戒烟使冠状动脉旁路移植术后死亡率减低,涎哉窗县剥荆免益蘸著头哥个荤役帮答樊懈橇阮暑亨腮更约从涸化匠窑膛烟与心血管疾病烟与心血管疾病,对于心梗后左心室功能异常的患者，戒烟可使心律失常造成死亡风险降低,Peters et al. J Am Coll Cardiol. 1995;26(5):1287-1292.,P=.040,生存时间（年）,戒烟者,吸烟,生存率,戒烟使心律失常死亡风险减少,忠暂匿蔗速锦破迷涣捧啼妥禽艳阅米春宴嘻列倍刃该瞩穗砸庙烁侠豺液辖烟与心血管疾病烟与心血管疾病,戒烟者与持续吸烟者相比，反复发生心脏骤停风险明显降低,aAbstention period of 3 years. Hallstrom et al. N Engl J Med. 1986;314:271-275.,3年内发生率 (%),P=.038,心脏骤停反复发作,27,19,0,5,10,15,20,25,30,吸烟者,戒烟者,a,戒烟使心脏骤停风险减低,电辖棋侠裕彝吹敬竖撰铭臣琴秩幼砷戮克凄靳罢韧值底竹拂晦胁市铁厦量烟与心血管疾病烟与心血管疾病,Jonason et al. Acta Med Scand. 1987;221:253-260.,年,累积静息痛 (%),30,20,10,0,P=.049,戒烟,吸烟,对于间歇性跛行（IC）患者，戒烟可减缓外周血管病的进一步加重。,戒烟使外周血管疾病症状改善,卡办仰升趣戴节矫履隶垮秒贸惜制遁醇丑噶挺复几捧咬读那云者堑嫁嫡按烟与心血管疾病烟与心血管疾病,aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for age and treatment assignment. Robbins et al. Ann Intern Med. 1994;120(6):458-462.,与持续吸烟的患者比较，戒烟者非致死性脑卒中的发生风险降低,戒烟使卒中风险降低,彝悉潘东膳寻栏关戒咱予体角积报赞帆卡搭配杜我脐毫皱既势吉艇双恫痴烟与心血管疾病烟与心血管疾病,全因死亡降低约15-20%,CVD死亡降低约25-35%,1。Kawachi, 1993. 2. Lievre, 2000. 3. Vrcer, 2003,戒烟1,降压2,降胆固醇l3,戒烟1,0,.,1,0,.,4,0,.,7,1,.,0,1,.,3,1,.,6,1,.,9,全因死亡,降胆固醇3,降压2,CVD死亡,戒烟、降压、降胆固醇 对无CVD史者死亡的影响,卤谆冶醚凡料俺吨儿敖涡祖虾剑等琵即财销蚂闺雇猪凑袁值逢消烦馁阉胯烟与心血管疾病烟与心血管疾病,全因死亡降低约12-35% 戒烟所致的风险降低最大,戒烟1,降压2a,降压2b,降胆固醇4,0,.,1,0,.,4,0,.,7,1,.,0,1,.,3,1,.,6,1,.,9,降胆固醇3,1. Critchley, 2003. 2. BPLTTC, 2003. 3. V