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??????S?

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Title: . . Author: Konstantinos Makrilakis Last modified by: TOSHIBA Created Date: 11/11/2002 8:06:49 AM Document presentation format – PowerPoint PPT presentation

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Title: ??????S?

1
??????S?

?S??S? ?-19
?O?/??S ?????????S
???????S ???/???? ?T??O?

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???S??S - ????????S? ?.?.
JNC VI Report Arch Intern Med 1997 157
2413-46 (??s?? ???? 2 ? pe??ss?te??? µet??se?? se
2 ? pe??ss?te?e? ep?s???e??)

?da???? S??lt120, ???lt80 mmHg
F?s???????? S??120-129, ???80-84 mmHg
???te?? f?s???????? S??130-139, ???85-89 mmHg
????????? ??????S?
S????? 1 S??140-159, ???90-99 mmHg
S????? 2 S??160-179, ???100-109 mmHg
S????? 3 S?? ? 180, ??? ? 110 mmHg

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???S??S - ????????S? ?.?.
JNC VII Report JAMA 20032892560 (??s?? ???? 2
? pe??ss?te??? µet??se?? se 2 ? pe??ss?te?e?
ep?s???e??)

?da???? S??lt120, ???lt80 mmHg
????p??tas? S??120-139, ???80-89 mmHg
????????? ??????S?
S????? 1 S??140-159, ???90-99 mmHg
S????? 2 S???160, ??? ? 100 mmHg

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?e??t?? ???a? S?µat?? (??S)Body Mass Index (BMI)

??S ????? (kg) / (?Y??? m)2
??S 82 / (1,68)2 29,1 kg/m2
??S 18,5-25 kg/m2 F?s????????
??S 25-30 kg/m2 ?p??ßa???
??S gt30 kg/m2 ?a??sa???? ßa?µ?? ?
??S gt35 kg/m2 ?a??sa???? ßa?µ?? ??
??S gt40 kg/m2 ?a??sa???? ßa?µ?? ???

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??????S??? ??F????S?????????T???

??T??S 1 ??af?? st???s? a?t???????? aµf/d???
??T??S 2 ?e?a?t??? st???s? s??????s?
t????µat?? a?t???????? s?µe?? Gunn
BAT??S 3 ??????se?? 2?? ßa?µ?? a?µ???a??e?
?/?a? e??d??µata aµf/d???
??T??S 4 ??????se?? 3?? ßa?µ?? ??d?µa ?pt????
?????

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?????G?S??S LDL-C

??p?? t?? Friedewald
LDL TC - HDL - (TG/5)
G?a TGlt 400 mg/dl
LDL-C 310 - 39 - (140/5) 243 mg/dl

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???t?µata p?? p??pe? ?a apa?t?se? ? ?at??? ??a
p??a?? ?pe?tas??? as?e??

??e? ?p??tas? ? ???
??? ?a?, ?d??pa??? ? ?e?te??pa???
?p?????? ß??ße? se te???? ???a?a-st????? (?a?d??,
?ef???, e???fa???, µ?t?a, a??e?a)
????? ? s???????? ?a?d?a??e?a??? ???d???? (µe
ß?s? ?????? s?µpa??µa?t???te? pa?????te?
???d????)

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???t?µata p?? p??pe? ?a apa?t?se? ? ?at??? ??a
p??a?? ?pe?tas??? as?e??

??e? ?p??tas? ? ???
??? ?a?, ?d??pa??? ? ?e?te??pa???
?p?????? ß??ße? se te???? ???a?a-st????? (?a?d??,
?ef???, e???fa???, µ?t?a, a??e?a)
????? ? s???????? ?a?d?a??e?a??? ???d???? (µe
ß?s? ?????? s?µpa??µa?t???te? pa?????te?
???d????)

S?st? µ?t??s? ?.?. ?pa?e???µµ???? se 3
t??????st?? ep?s???e??

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???t?µata p?? p??pe? ?a apa?t?se? ? ?at??? ??a
p??a?? ?pe?tas??? as?e??

??e? ?p??tas? ? ???
??? ?a?, ?d??pa??? ? ?e?te??pa???
?p?????? ß??ße? se te???? ???a?a-st????? (?a?d??,
?ef???, e???fa???, µ?t?a, a??e?a)
????? ? s???????? ?a?d?a??e?a??? ???d???? (µe
ß?s? ?????? s?µpa??µa?t???te? pa?????te?
???d????)

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??????S?

??????T?S (90-95)
?????????T?S (5-10)

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???????G?? - ????G????S ???????? ?????????T??S
??????S?S

?ef????? ??s?? (spe??aµat???? -?ef?a??e?a???)
???t?pa??? ?pe?a?d?ste????sµ??
Fa?????µ???tt?µa
?p?- ?pe?-???e?e?d?sµ??
?pe?pa?a???e?e?d?sµ??
S??d??µ? Cushing
?s?µ??? st???s? a??t??
??t?s????pt???
S??d??µ? ?p???a? ?at? t?? ?p?? (sleep apnea)

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???t?µata p?? p??pe? ?a apa?t?se? ? ?at??? ??a
p??a?? ?pe?tas??? as?e??

??e? ?p??tas? ? ???
??? ?a?, ?d??pa??? ? ?e?te??pa???
?p?????? ß??ße? se te???? ???a?a-st????? (?a?d??,
?ef???, e???fa???, µ?t?a, a??e?a)
????? ? s???????? ?a?d?a??e?a??? ???d???? (µe
ß?s? ?????? s?µpa??µa?t???te? pa?????te?
???d????)

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F?S??? ?S????? ?.?.
G?????? - ??????????
?????? 0-30
???-??????S??? ???????S
F?S????-G??? ?.?.
??O??? ??????S?
20-40
?G????S?????? ??????S?
30-50
?O??S ????????S
?? ????????S
????????????? ?????T?S ??????
?????? ???????F?? ?????????? ??F??G??
??G??? ?GG??? ??????S?? ????O??S??S
?G??F???S ?S?????? T????OS? ???????G??
??F??? ??F??S???-???S? ??????????
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???t?µata p?? p??pe? ?a apa?t?se? ? ?at??? ??a
p??a?? ?pe?tas??? as?e??

??e? ?p??tas? ? ???
??? ?a?, ?d??pa??? ? ?e?te??pa???
?p?????? ß??ße? se te???? ???a?a-st????? (?a?d??,
?ef???, e???fa???, µ?t?a, a??e?a)
????? ? s???????? ?a?d?a??e?a??? ???d???? (µe
ß?s? ?????? s?µpa??µa?t???te? pa?????te?
???d????)

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?a?????te? ???d???? ??a ?a?d?a??e?a?? ??s?µata

???p?p???s?µ??
??p??sµa
??s??p?da?µ?a
????? LDL ????ste????
?aµ??? HDL ????ste????
????? t??????e??d?a
?p??tas?
Sa??a??d?? ??aß?t??
?a??sa???a
??a?t?t???? ?a?????te? (??p??)
???e??? S?µat???? ??ast????t?ta?
?pe?ß????? p??s???? ????p?e?µat??
???s? ???a????

??-t??p?p???s?µ??
?t?µ??? ?st????? S?
?????e?e?a?? ?st????? p???µ?? S?
?????a
F???
?e?te??? ?a?????te?
?pe??µ???ste??a?µ?a
???d?????
CRP, IL-6
???µ?de?? ?a?????te?
??aµ?d?a, CMV, H. Pylori
PAI-1
??????e???µat??????a

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St? ?e???t??? ?????a (gt60 et??) ? S?? ?a? ? ??es?
Sf??µ?? (S??-???) e??a? p?? ?s????? p??d?a?es????
pa?????te? ??a t?? a??pt??? S? ?a? ??? ap? t? ???

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?????S? ??????S???? ?ST????S

?st?????
??t??e?µe???? e??tas?
???ast???a??? e?et?se??
???t??a?
??d????
??t?µ?s? ß??ß?? te????? ???????-st????
??t?µ?s? s???????? ?a?d?a??e??a??? ???d????
?p???e?sµ?? de?te??pa??? a?t??? ?

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??G?S???????S ?????S??S

???????S Ge???? a?µat??, Ge???? ?????, s???a??,
????a, ??eat?????, ?pat??? ????µa, ?, ?a, Ca,
??G, ?/a T??a?a
??????S ??????a µe ta e???µata ap? ?st?????,
s?µat??? e??tas? ?a? e?et?se?? ???t??a? ??a
ap???e?sµ? de?te??pa???? ?

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S? ?? S???????? ? SO?????? ?????S? ???
??G?S???????S ?????S??S

St?? ep?ßeßa??s? ?pa???? ?
St?? e?t?µ?s? s???????? ?a?d?a??e?a??? ???d????
St?? e?t?µ?s? ?pa???? ß??ß?? te?????
???????-st????
St?? ap???e?sµ? ? ep?ßeßa??s? de?te??pa??? a?t???

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F?S??? ?S????? ?.?.
G?????? - ??????????
?????? 0-30
???-??????S??? ???????S
F?S????-G??? ?.?.
??O??? ??????S?
20-40
?G????S?????? ??????S?
30-50
?O??S ????????S
?? ????????S
????????????? ?????T?S ??????
?????? ???????F?? ?????????? ??F??G??
??G??? ?GG??? ??????S?? ????O??S??S
?G??F???S ?S?????? T????OS? ???????G??
??F??? ??F??S???-???S? ??????????
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???????G?? - ????G????S ???????? ??????T??S
??????S?S