PDF《in炉he爉anagement爋f燞eart焖ailure?》

? Desk? Reference? Book? (PDR)? [available?upon?registration?at?the?URL:?http://www.pdr.net/login/Login.aspx.]:? - chlorothiazide? - hydrochlorothiazide? - bendroflumethiazide? ?

3 - cyclopenthiazide? - methyclothiazide? - trichlormethiazide? - benzthiazide? - hydroflumethiazide? - chlorthalidone? - indapamide? - xipamide? ? 5.?Formulation?proposed?for?inclusion;

?including?adult?and?paediatric?(if?appropriate)? Hydrochlorothiazide?is?taken?as?the?reference?drug?for?the?whole?class?of?thiazide?diuretics?and? thiazide\like? diuretics.? It? is? proposed? to? maintain? hydrochlorothiazide? in? the? Model? List? of? Essential?Medicines,?as?in?the?subsection?12.4?Medicines?used?in?heart?failure?of?the?current?edition? (EML?15,?revised?March?2007)?with?the?following?possible?formulations:? ? Hydrochlorothiazide?? tablets?25,?50,?100?mg;

?? capsules?12,5?mg?;

? oral?suspension?50?mg/5?ml.? ? Other? members? of? the? class? may? be? used? as? alternatives,? depending? on? quality,? price? and? local? availability.? ? 6.?International?availability?\?sources,?if?possible?manufacturers?(Annex?A)? A?comprehensive?listing?for?thiazide?diuretics?is?available?in?Annex?A.? Generic? thiazide? diuretics? are? registered? in? many? countries? in? the? developed? and? developing? world.?Their?choice?will?depend?on?their?prices?and?availability?at?local?(national)?level.? ? 7.? Whether? listing? is? requested? as? an? individual? medicine? or? as? an? example? of? a? therapeutic? group? ? Listing?is?requested?on?the?Model?List?of?Essential?Medicines?as?a?single?drug?(as?already?in?the? subsection?12.4?Medicines?used?in?heart?failure,?of?the?current?EML).?Among?the?whole?class?of? thiazide? diuretics? hydrochlorothiazide? is? taken? as? the? drug? of? reference.? Other? members? of? the? class?may?serve?as?alternatives,?depending?on?quality,?price?and?local?availability.? ? 8.?Information?supporting?the?public?health?relevance?(epidemiological?information?on?disease? burden,?assessment?on?current?use,?target?population)? As? stated? in? the? 2003? World? Health? Organization? (WHO)? document? on? prevention? of? cardiovascular?disease,? non\communicable?disease?accounts?for?a?large?and?increasing?burden?of? disease?worldwide ?(WHO?2003).?Cardiovascular?disease?(CVD)?is?the?most?important?single?cause? of? non\communicable? disease,? accounting? in? 2001? for? 29%? of? all? deaths? and? 10%? of? the? global? disease?burden.?Although?the?incidence?of?CVD?has?been?decreasing?over?the?last?20?years?in?many? high\income? populations,? its? incidence? in? low? and? middle\income? populations? has? been? rising? steadily,? due? to? ageing? of? the? population? and? to? better? control? of? communicable? disease? and? ?

4 malnutrition,?so?that?approximately?three\quarters?of?global?deaths?from?CVD?now?occur?in?those? populations?(Figure?1).?This?is?especially?true?in?sub\Saharan?Africa,?India,?China?and?Russia.? World\wide,?deaths?from?cardiovascular?disease?exceed?those?caused?by?cancer,?infectious?disease? and?trauma,?constituting?a?deadly?epidemic.?It?is?predicted?that?in?the?next?two?decades?there?will? be?tripling?of?ischemic?heart?disease?and?stroke?mortality?in?Latin?America,?the?Middle?East?and? sub\Saharan?Africa?(Callow?2006).? ? Changes?in?death?rates?from?coronary?heart?disease,?men?and?women?aged?35?to?74,?between?1990? and?2000,?selected?countries? ? ? Notes:? ICD? codes? 410\414? (8th? and? 9th? Revision),? I20\I25? (10th? revision).? Age\standardised? using? the? European?standard?population.?Sources:?World?Health?Organization?(2004)?www3.who.int/whosis? ? HF? is? a? complication? of? coronary? artery? disease,? hypertension,? valvular? disease? and? acute? myocardial? infarction.? Based? on? studies? conducted? in? western? countries? the? lifetime? risk? of? developing?HF?is?about?20%?for?both?men?and?women?(Lloyd\Jones?2001).?Data?on?HF?prevalence? in? developed? countries? range? from? 2%? in? USA? and? Europe? (Davies? 2001)? to? more? than? 6%? in? Australia?(Abhayaratna?2006).?Once?HF?has?developed?the?median?survival?time?is?1.7?years?for? men?and?3.2?years?for?women.?Five?year?mortality?rate?is?50%?for?both?sexes.?Mortality?associated? with?HF?over?the?past?20?years?has?declined?significantly?in?men;