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Hypertension：不容错过！高血压儿童降压药的更佳选择

2018-08-15 吴星 环球医学

高血压儿童
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对生活方式的改变反应迟钝的高血压儿童和青少年进行药物治疗，但没有充足的证据推荐首选1级降压药物。2018年8月，发表在《Hypertension》的一项网络荟萃分析，比较现有关于儿童高血压药物治疗的随机临床试验的结局。

对生活方式的改变反应迟钝的高血压儿童和青少年进行药物治疗，但没有充足的证据推荐首选1级降压药物。2018年8月，发表在《Hypertension》的一项网络荟萃分析，比较现有关于儿童高血压药物治疗的随机临床试验的结局。

从共计554项潜在相关研究中，纳入13项随机安慰剂对照临床研究，这些研究均涉及≥50例患者，随访时间≥4周。治疗后收缩压（SBP）和舒张压（DBP）的降低为共同主要终点。

分析共纳入2378例儿童患者，中位年龄为12岁。在中位随访35天后，研究者发现赖诺普利和依那普利在降低SBP和DBP方面优于安慰剂，而对于DBP而言，氯沙坦优于安慰剂，赖诺普利和依那普利优于依普利酮。与安慰剂相比，血管紧张素转化酶抑制剂和血管紧张素受体阻断剂与更大幅度的SBP和DBP降低相关。同样，盐皮质激素受体拮抗剂在降低DBP方面劣于血管紧张素转化酶抑制剂。这项分析校正了研究层面的平均年龄、女性比例、平均基线血压，以及平均体重，只有后者显著影响DBP降低。

根据目前的分析，血管紧张素转化酶抑制剂和血管紧张素受体阻断剂代表着儿童高血压降压治疗的最佳选择。然而，由于缺乏其他类型降压药的相关数据，尚不能得出明确的结论，需要进一步的随机对照试验来证实。

原始出处：

Burrello J, Erhardt EM, Saint-Hilary G, et.al. Pharmacological Treatment of Arterial Hypertension in Children and Adolescents: A Network Meta-Analysis. Hypertension. 2018 Aug;72(2):306-313. doi: 10.1161/HYPERTENSIONAHA.118.10862. Epub 2018 Jul 2.

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    2019-04-29 feather89

    #PE#

    0

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    2019-06-26 12498ebem19暂无昵称

    #TENS#

    0

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    2018-08-17 经常头晕

    #降压#

    0

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    2018-08-17 jambiya

    #Hypertension#

    0

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    2018-08-15 liumin1987

    儿童高血压的治疗。

    0

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