Hypertension 高血壓 Stroke Dr. Hildemar Dos Santos 山度士醫生 Assistant Professor Loma Linda University School of Public Health Former Director of the Lifestyle Management Centre 健康生活促進中心 Hong Kong Adventist Hospital 香港港安醫院 Tsuen Wan Adventist Hospital 荃灣港安醫院 Stroke
Stroke Types 不同類型的中風 香港 - 68.3%局部缺血的， 27.1%出血的， 4.5% 不明 - 1992 香港中文大學 Western 80% ischemic, 20% hemorrhagic 西方: 80% 局部缺血的， 20% 出血的 China - 62.4% ischemic, 29.3% hemorragic, 8.3% unknown - Lin-Feng Zhang et all, 2003 中國 - 62.4%局部缺血的， 29.3%出血的 Hong Kong - 68.3% ischemic, 27.1% hemorrhagic, 4.5% unknown - R. Kay et al, 1992 - Chinese University of Hong Kong 香港 - 68.3%局部缺血的， 27.1%出血的， 4.5% 不明 - 1992 香港中文大學
局部缺血 中風 出血的 血凝塊 頸動脈 的疾病
Get to the hospital in less than 60 min! 視力有困難 行路有困難 Get to the hospital in less than 60 min! 60分鐘內到達醫院 講話有困難 身體一邊軟弱
Fruits and Vegetables and Strokes 水果、蔬菜與中風 Danish Diet, Cancer and Health study Johnsen et all, 2003 丹麥食療、癌症與健康的研究 Those who eat 673 g of fruits and vegetables have 30% less risk of ischemic stroke 吃超過673克水果及蔬菜的人患局部缺血中風的危機會減少30%
Whole Grain Consumption and Stroke Risk 進食全麥與中風的危機 The Nurses’ Health Study - 12 years FU 護士健康研究 - 12年跟進 75,521 women in the US 美國75,521 名女士 38-63 years 年齡 38-63歲 Whole grains: brown rice, oatmeal, whole wheat bread and products 全麥: 糙米、燕麥、全麥麵包等 40% reduction of strokes among those regular whole grain users全麥食用者中風的機會減少40% JAMA, September 27, 2000 - Vol 284, No. 12
Hypertension in Hong Kong 香港的高血壓情況 17% of the population: +- 1,000,000 佔人口的百分之17 Obese people have higher risk of hypertension 肥胖人士患高血壓的危機較高
減去10公斤的體重可另血壓降5-20點
DASH Dietary Approaches to Stop Hypertension
Limit alcohol intake, if used at all 如飲用酒精, 盡量減少份量 BP drops 2-4 points by limiting alcohol -減少酒精可降血壓2-4點
Hypertension and Anger 血壓高及憤怒 Dr. Dick Tibbits Tibbits醫生 Results: Learn how to forgive can lower blood pressure on patients with high levels of anger. 效果: 患高血壓的人如學怎樣寬恕可以降低血壓
Blood pressure and anger 血壓與憤怒 Initial Blood Pressure 最初血壓 Final Blood Pressure 最後血壓 Patient # 病人 # Anger Score 憤怒指標 (Red 紅色) 1 34 144/97 130/81 2 28 154/98 124/76 3 26 151/99 132/86 4 26 157/107 123/84 5 19 153/87 124/80 Tibbits, 2004
Soy and Hypertension 大豆與高血壓 Shanghai Women’s Health Study 上海婦女研究 45,694 participants - 2 - 3 years follow up 45,694人參與 - 二至三年跟進 Compared women who ate 25 g soy protein/day with those who took less than 2.5 g soy protein/day 每日食用25克大豆蛋白質的女士與每日食用多過25克的女士比較地 American Journal of Clinical Nutrition 2005; 81:1012-1017
Soy protein contents 大豆蛋白質的含量 1 cup cooked soybeans = 28.6 g 1杯熟的王豆 = 28.6 克 1/2 cup tofu raw = 10g 半杯生豆腐 = 10 克 1/2 cup tofu firm = 19g 半杯硬豆腐 = 10 克 1 cup soybean milk = 6.6 g 1杯豆奶 = 6.6克 1/2 cup green soybeans = 11g 半杯綠大豆 = 11克
Garlic and Hypertension 蒜頭與高血壓 Garlic can drop 8-11 mm Hg for the systolic and 5 - 8 mm Hg for the diastolic 蒜頭可降低收縮壓 8-11 mm Hg 及舒張壓 5 - 8 mm Hg Garlic Daily Dose 每日食用蒜的份量: 4,000 mcg of Allicin 4,000 mcg 蒜素 4 g of fresh garlic 4克新鮮蒜頭 1 - 4 garlic cloves 1-4 瓣蒜頭 Encyclopedia of Natural Medicine page 527
Framinghan Heart Study Framinghan 心臟研究 (Franco et all, 2004) Chocolate - 100 g day reduces systolic blood pressure by 5.1 mm Hg, and diastolic by 1.8 mm Hg 朱古力 - 每日100克可降低收縮壓5.1 mm Hg及舒張壓1.8 mm Hg 400 g of fruit and vegetables/day - similar results as chocolate 每日吃400克水果及蔬菜會有同樣的效果
Encyclopedia of Natural Medicine page 527 CoQ10 and Hypertension (Lowers Peripheral Resistance?) 輔酵素Q10與高血壓 (降低外周的阻力?) 39% of hypertension patients are deficient 高血壓患者當中35百分比欠缺 Some small studies have found a lower effect of CoQ10 on hypertension 有研究顯示C0Q10有助降低高血壓 Ten patients with high blood pressure 十個患高血壓的病人 100 mg CoQ10/ day - 10 weeks 每日100 mg - 10星期 Systolic from 161 to 142 mmHg 收縮壓由 161 降至 142 Diastolic from 98.5 to 83 mmHg 舒張壓由98.5降至83 Encyclopedia of Natural Medicine page 527
Vitamin C and Hypertension 維他命C 與高血壓 Study 2g loading dose 研究 - 開始兩克 500 mg/daily - 30 days 每日500毫克 - 30日 Decrease systolic pressure by 13 mm Hg 降低收縮壓13 mm Hg No effect on diastolic 舒張壓沒影響 Increased Nitric Oxide 增加氧化氮 Lancet, 1999;354:2048-2049 醫學雜誌Lancet