Hội Tim mạch học Việt Nam

Diabetes and CVD burden in Asia population National Center for Global Health and Medicine Tokyo, Japan Hiroshi Kajio, M.D., Ph D/ Diabetes and CVD Diabetes Population in 2010 and 2030 Europe 58.70 million ↓ + 20.0% 66.2 million North America 37.4 million ↓ + 42.4% 53.2 million Med & Middle East SE Asia West pacific 26.6 million 58.7 million 76.7 million ↓ + 93.9% + 72.1% + 47.0% ↓ ↓ 51.7 million 101 million 112.8 million Africa 1210万人 + 98.1% ↓ 2390万人 South and Central America 18 million + 65.1% ↓ 29.6 million Total 28.46 million in 2010 ↓ 43.84 million in 2030 + 54.0% IDF Map in 2009 Prevalence of DM in 1970-1989 and in 1990-2005 Prevalence of Type diabetes Multiplication factor for increase prevalence Relative Risk of CVD In Patients with IGT and DM The Hisayama Study ＊＊ 3.0 ※Cardiovascular ＊ disease ＝Ischemic heart disease and Stroke Relative risk adjusted for age Relative risk of CVD 2.0 Relative risk adjusted for Age, sex, blood pressure, BMI, ECG abnormality, T-chol, HDL-C, tobacco and alcohol ＊ ＊ ＊p＜0.05 vs Normal ＊＊p＜0.01 vs Normal 1.0 Subject: 2,427 residents Age: 40 -79 yrs Previous history: stroke (-) MI (-) Follow-up period: years Normal （n=1,693） IGT （n=474） DM （n=260） Fujishima M, et al: Diabetes, Vol.45 Suppl 3, S14-S16, 1996 Abnormality of glucose tolerance in patients with CHD Caucasian AMI Japanese ＣＨＤ Norhammar A et al Lancet 2002: 359, 2140-44 Satoh H et al.: Heart 2005: 91: 731-36 Age-standardized death rates per 100 000 for stroke and CHD across countries in different regions of Asia in 2002 Stroke CHD Ueshima, H et al Circulation 2008;118:2702-2709 CVD Risk Factors Association of risk factors with acute myocardial infarction in men and women after adjustment for age, sex, and geographic region Yusuf S etal.: Lancet 2004; 364: 937– 52 Risk of acute myocardial infarction associated with exposure to multiple risk factors Smk=smoking DM=diabetes mellitus HTN=hypertension Obes=abdominal obesity PS=psychosocial RF=risk factors Yusuf S etal.: Lancet 2004; 364: 937– 52 Metabolic Syndrome 住民レベルでの実態調査 Population-based Study in Asian countries China 1246→460 Beijing Taiyung 1213 1516 Hanoi Ragama community Kelaniya University 3012 Sri Lanka 403 Tea Factory Thai Binh Nuwara Eliya 2000 Vietnam Metabolic Syndrome Waist Circumference Accumulation of risk factors Cross-sectional Study Onset of disease Follow-up Study Definition of the state of risk-factor clustering （NCEP-ATPⅢ except for waist circumference） （１） （２） Triglycerides ≧150mg/dl （３）Systolic blood pressure ≧130mmHg or Diastolic blood pressure ≧85mmHg （４） HDL cholesterol Fasting plasma glucose 140/90 mm Hg in 2000 and Predicted... overall CHD Ischemic stroke Hem stroke Nakamura, K et al Stroke 2008;39:1694-1702 Map showing the estimated age- and sex-standardized prevalence of hypertension in each region of China High Prevalence