May 17, 2022 is the 18th “World Hypertension Day” in the world. The theme of this year’s World Hypertension Day is “Accurate Measurement, Effective Control, Health. longevity”. Hypertension and hyperlipidemia are the most important risk factors for atherosclerotic cardiovascular disease (ASCVD), which seriously affect the life safety of the majority of patients. The significance of ASCVD events, Hanhui Pharmaceutical will hold the “2022 Blood Pressure and Lipid Week Special Event” around this year’s World Hypertension Day, inviting well-known experts in the field of cardiovascular disease diagnosis and treatment in my country to discuss the current status of blood pressure and blood lipid management in my country, and look forward to comprehensive management. Future direction. The special invitation to Peking University People’s HospitalHospitalProfessor Ji Linong , to expound the significance of comprehensive management of multiple risk factors for reducing the risk of ASCVD in diabetic patients, and to interpret the unique advantages of combined antihypertensive/lipid-lowering drug treatment strategies.
Professor Ji Linong, Peking University People’s Hospital
Outpatient Clinic:< span>At present, more than 70% of China’s diabetic patients have cardiovascular diseases such as hypertension and dyslipidemia. Following the concept of “three highs” co-management first proposed by the “Healthy China Action (2019-2030)”, hypertension should be done at the same time. , Diabetes, dyslipidemia standardized management. What do you think of the importance of “three highs” comprehensive management in reducing the risk of ASCVD in patients with diabetes?
Professor Ji Linong:Relevant epidemiological data show that the detection rate of hypertension in patients with diabetes is about 60%, while the prevalence of hypertension in patients with hypertension is about 60%. The detection rate of diabetes is 24.3%-70.3%, and the rate of type 2 diabetes patients with dyslipidemia in my country is 78.51%. Therefore, both for diabetic patients and non-diabetic patients with high risk of cardiovascular disease, active control of blood pressure and blood lipids is recommended. Management is very important.
There has been sufficient evidence-based medical evidence in the past that, on the basis of hypoglycemic therapy, combined antihypertensive and/or lipid-lowering therapy can significantly improve the occurrence and development of cardiovascular and cerebrovascular diseases in diabetic patients. risk of death. However, from the current status of chronic disease management in my country and even in the world, the overall control of blood pressure, blood lipids and blood sugar in diabetic patients is not optimistic. For example, the results of a national cross-sectional survey covering more than 100 centers, the “3B Study”, showed that only 5.6% of the patients with type 2 diabetes in my country reached the target blood pressure, blood lipid and blood sugar levels, and a large proportion of Patients are far from meeting the guidelines for blood pressure, blood lipids, and blood sugar control. In addition, according to the survey results of the 3B study, the application rate of statins in patients with type 2 diabetes is only 20%, and even for patients with cardiovascular and cerebrovascular diseases, the proportion of receiving statins is only 40%; and if According to the recommendations and recommendations of relevant guidelines at home and abroad, almost all patients with type 2 diabetes have indications for statin therapy, and patients with cardiovascular disease should be given statin therapy; but as shown by the 3B study, the real The application rate of statins in patients with type 2 diabetes in the world is still far from enough, and efforts should be made to narrow the gap between clinical practice and evidence-based medical evidence and guideline recommendations in the future. At the same time, a number of previous clinical studies have shown that while strict blood pressure control and blood lipid control in patients with type 2 diabetes, combined with intensive blood sugar control can significantly reduce the risk of type 2 diabetes in patients with high cardiovascular disease risk. Cardiovascular and cerebrovascular disease occurrence and risk of death. Therefore, in the future clinical work, we should also follow the guidelines and standard treatment, and strictly control blood pressure, blood lipids and blood sugar in diabetic patients, and further improve the compliance rate of hypertension, hyperlipidemia and hyperglycemia, especially to improve these three important The comprehensive compliance rate of cardiovascular disease risk factors in China is believed to be of great significance for the improvement of prognosis, prolongation of life span and improvement of quality of life for the majority of diabetic patients.
Combined lipid-lowering, combined antihypertensive
Outpatient Clinic:For high-risk/very high-risk ASCVD patients with hypertension, hyperlipidemia and other risk factors, lowering blood pressure and lipids is a core strategy for ASCVD prevention and management. There are still many deficiencies in the management of blood lipids in these patients. What do you think are the unique advantages of simultaneous blood pressure and lipid lowering strategies and the treatment strategy of statins combined with cholesterol absorption inhibitors?
Professor Ji Linong:Statins combined with cholesterol absorption inhibitors have been proven to have good synergistic effects and good safety. Combining lipid-lowering with statins can further improve the risk of cardiovascular disease, and has become the preferred combination regimen for cholesterol-lowering therapy recommended by domestic and foreign guidelines. In clinical practice, the use of moderate-intensity statins for the treatment of cholesterol, especially low-density lipoprotein cholesterol levelsFor patients who do not meet the standard or are intolerant, the combined use of cholesterol absorption inhibitors can be considered on the basis of statin therapy to further improve the control rate of cholesterol levels. A number of high-quality evidence-based medical studies in the past have shown that the combined use of cholesterol absorption inhibitors and statins can significantly increase the magnitude of lowering cholesterol levels, thereby further increasing the risk of cardiovascular and cerebrovascular diseases and death in patients at high risk of cardiovascular disease. reduce. Cholesterol absorption inhibitors used to be imported ezetimibe, and now there is a new domestic class I drug, Hypomabu, on the market, providing more effective options for our Chinese people’s lipid-lowering treatment.
In addition to intensive lipid-lowering, intensive antihypertensive therapy is also the focus of the majority of clinicians. According to the results of previous studies on the treatment of type 2 diabetes, intensive blood pressure control in patients with type 2 diabetes can effectively reduce the risk of myocardial infarction, stroke or death due to myocardial infarction and stroke. From this point of view, if the blood pressure and blood lipids in patients with type 2 diabetes cannot be controlled at the same time, the treatment strategy of thiazide diuretics or long-acting calcium antagonists combined with statins can be selected in this case. However, it is worth noting that the unsatisfactory compliance of blood pressure lowering and lipid lowering is a key problem currently faced in clinical practice, and the fixed-dose compound preparation composed of amlodipine and atorvastatin – amlodipine atorvastatin The listing and clinical use of SPC provide a new means and method for comprehensive management of blood pressure and blood lipids, which can not only effectively improve the efficacy of comprehensive interventions on blood pressure and blood lipids, but also effectively improve patients’ treatment compliance, thereby ensuring patients’ blood pressure. It has obvious advantages in the treatment of high-risk/very-high-risk ASCVD patients with risk factors such as hypertension, hyperlipidemia, hyperglycemia and other risk factors who need combined medication.
Take the road of Chinese medical innovation, practically change the treatment status of Chinese patients, and help realize the grand goal of “Healthy China 2030”. I wish the 2022 Hanhui Blood Pressure and Lipid Week activities a complete success!
——Professor Ji Linong’s Message
Extended Reading< /span>
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