coveram-symcard-dr-yerizal.pdf

The Rationale of Fixed Combination in the Management of Hypertension Foc us on A CE -I and CC B

Yerizal Karani

Current Status of Hypertension

Measure

n (95% CI)

Total number worldwide in 2000 Total number in economically developed countries in 2000

972 million (957-987) 333 million (329-336)

Total number in economically developing countries in 2000

639 million (625-654)

Total number worldwide in 2025

1.56 billion (1.54-1.58)

Kearney PM et al.

Lancet

2005; 365:217-223.

Prevalence of HT based on gender (Basic Health Research / Indonesian Health Departement 2007) Men

Women

35

31.3 31.9

30

% 25 e c 20 n e l 15 a v e r10 P 5

8.6

5.8

9 6.1

0 D

D/O

U

Dasar Diagnosis Keterangan :

D D/O U

= Diagnosis berdasarkan tenaga kesehatan = Diagnosisi berdasarkan tenaga kesehatan atau kasus minum obat = Diagnosis berdasarkan hasil pengukuran tekanan darah

50 Biennial ageadjusted rate per 1000 patients

Coronary disease

Stroke

40

Peripheral artery disease

Heart failure

Normotensie Hypertensive

30 20

10 0 Risk ratio:

Men Women 2.0 2.2

Kannel WB. JAMA. 1996;275:1571-1576.

Men Women 3.8 2.6

Men Women 2.0 3.7

Men Women 4.0 3.0

Cardiovascular mortality risk 8

8X risk

6 4

4X risk

2 1X risk

2X risk

115/75

135/85

0 155/95

175/105

Systolic BP/Diastolic BP (mmHg)

*Individuals aged 40–69 years

Lewington et al. Lancet 2002;360:1903 –13

Takeda Chemical Industries, 1998

Treating hypertension reduces cardiovascular morbidity and mortality Relative risk (%) 0

CHF

Stroke

CV mortality

Major coronary event

All deaths

* –20

*** –40

*** ***

–60

**

***

‘Older’ patients (mean >65 years) ‘Younger’ patients (