Hypertension:难治性高血压患者暂时停降压药安全吗?

2017-04-04 xing.T MedSci原创

总之,对高血压诊断评估时,停止服用抗高血压药物并不增加心血管事件的急性风险,但需要在一个具有适当的程序和监测安全的专业医院进行。

血压的成功控制依赖于确定高血压的继发性原因和导致高血压的因素。由于抗高血压药物可以干扰诊断性调查,因此,建议暂时性停止用药。然而,对于难以控制的高血压患者暂时性停止抗高血压药物的安全性存在担忧。近日,血管权威杂志Hypertension上发表了一篇研究文章,在2010年2月至2016年3月期间的复杂高血压筛查项目分析(n=604)时,研究人员旨在评估了可能归因于暂时停止抗高血压药物的潜在血管和脑血管事件发生率。

研究人员从SMART研究(动脉疾病的第二表现研究)队列(由研究者所在医院类似的一个队列组成,他们没有暂时停止抗高血压药物)中抽提出对照组组(n=604),并且这些个体与实验组具有匹配的血压、年龄、性别和心血管疾病病史。

停用药物的耐受性良好,62%的患者没有报告并发症,24%的患者有轻微的不适,并且可以不处理,14%的患者经验的并发症需要处方抗高血压药物来治疗。在复杂高血压分析组中有3例高血压患者在停药后与用药后30天之间发生了主要不良事件(事件发病率为31.2次每1000人每年)。在对照队列中,在同样的随访期间发生了5例心血管事件(事件发生率为51.2次每1000人每年)。

总之,对高血压诊断评估时,停止服用抗高血压药物并不增加心血管事件的急性风险,但需要在一个具有适当的程序和监测安全的专业医院进行。

原始出处:

Martine M.A. Beeftink, et al. Safety of Temporary Discontinuation of Antihypertensive Medication in Patients With Difficult-to-Control Hypertension.Hypertension. 2017. https://doi.org/10.1161/HYPERTENSIONAHA.116.08793

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    2017-11-29 feather89
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createdBy=5fca128, createdName=licz0423, createdTime=Mon Sep 11 20:30:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726338, encodeId=626b1e26338b8, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Nov 29 11:30:00 CST 2017, time=2017-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185579, encodeId=4b481855e90f, content=不错,得及时更新观念, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Thu Apr 06 02:30:00 CST 2017, time=2017-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501145, encodeId=7570150114585, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Thu Apr 06 02:30:00 CST 2017, time=2017-04-06, status=1, ipAttribution=), 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
    2017-04-06 孙文杰

    不错,得及时更新观念

    0

  5. 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
  6. 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  7. 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
  8. 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
    2017-04-06 freve
  9. 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
    2017-04-05 明天会更好!

    学习了,很好的一篇文章!!!

    0

  10. 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2017, time=2017-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185207, encodeId=d6ef18520e69, content=试试其他方法, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/AiafG5m7kibldQyTnpaQicxg1rnBqFdIGgQBJJs4lR8ibmh91PibzgL7R7pl2HSBjgFeeKRV0mMCvDh49LrgJPCYYvA/132, createdBy=abc91707732, createdName=qjzhai1623, createdTime=Wed Apr 05 00:05:24 CST 2017, time=2017-04-05, status=1, ipAttribution=)]
    2017-04-05 qjzhai1623

    试试其他方法

    0

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难治性高血压是指在尽管服用3种或3种以上的降压药后血压仍然偏高的一种危险疾病。随着老龄化的来临和肥胖的持续流行,估计难治性高血压的患病仍将增加。 今年早些时候,备受期待的SYMPLICITY HTN-3肾脏去神经试验(美敦力公司)未能达到主要有效终点—基线期诊室收缩压到6个月后无明显变化。令人失望的研究结果让心脏病病学团体怀疑—去肾脏神经术是否还能作为难治性高血压的治疗方法。但也有部分专

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