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CHIẾN LƯỢC PHỐI HỢP THUỐC HIỆU QUẢ, VAI TRÒ NỀN TẢNG CỦA ƯCMC TRONG BẢO VỆ TIM MẠCH

CHIẾN LƯỢC PHỐI HỢP THUỐC HIỆU QUẢ, VAI TRÒ NỀN TẢNG CỦA ƯCMC TRONG BẢO VỆ TIM MẠCH

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CHIẾN LƯỢC PHỐI HỢP THUỐC HIỆU QUẢ, VAI TRÒ NỀN TẢNG CỦA ƯCMC TRONG BẢO VỆ TIM MẠCH

  1. 1. GS. TS. VÕ THÀNH NHÂN ĐH Y Dược – BV Chợ Rẫy TPHCM
  2. 2. Hypertension World Prevalence Diagnosis % of Diagnosed BP Controlled Millions 2000 2025
  3. 3. Intermediate “Aiming” Targets
  4. 4. Cerebral Infarction Myocardial Infarction Sudden Death Stable Angina Protecting the Patient from Cardiovascular Events
  5. 5. factor). This imbalance contributes to progression of hypertension and associated cardiovascular risk. In the newly diagnosed individual with hypertension, whether young or old, the vascular
  6. 6. controlled trial. LANCET Volume: 366 Issue: 9489 Pages: 895-906 Published: SEP 10 2005.
  7. 7. Endothelium Endothelium Tunic Intima Lipid Macrophages Neointima Protecting the Endothelium & Intima
  8. 8. AT2 AT1 Apoptosis Endothelial Disruption Protecting the Endothelium & Intima
  9. 9. AT2 AT1 Apoptosis Endothelial Continuity Protecting the Endothelium & Intima
  10. 10. Physiological Effects of Bradykinin
  11. 11. Pertinent Sub-study Perindopril Increases Bradykinin Concentration
  12. 12. Effective Treatment of Coronary Artery Disease Fox KM et al EUROPA Trial Lancet. 2003 Sep 6;362(9386):782-8.
  13. 13. Collagen Fibres Prevention of Vascular Changes in Hypertension
  14. 14. Change in Mean Brachial Blood Pressure (mmHg) Effective Treatment of Hypertension
  15. 15. Brachial SBP Central SBP Brain Heart Kidney Arm Effective Treatment of Hypertension Williams B et al. CAFÉ Study Circulation 2006; 113:1213-25.
  16. 16. Effective Treatment of Hypertension Dahlof B et al. ASCOT-BPLA Study Lancet 2005; 46:895-906.
  17. 17. Which combination?
  18. 18. Which combination is the best?
  19. 19. Vs. “Which combination is best ?”
  20. 20. Winning Combinations
  21. 21. Losing Combinations Never played e.g.
  22. 22. “Which combination is best ?”
  23. 23. EURO 2016– Man of the Match / Golden Ball
  24. 24. ADVANCE trial- CCB Analysis
  25. 25. ADHERENCE --------> BP LOWERING ----> CARDIOVASCULAR PROTECTION

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