J Am Heart Assoc:螺内酯可改善保留射血分数的心衰患者的顽固性高血压

2021-06-10 MedSci原创 MedSci原创

顽固性高血压可能是机体不适当的醛固酮分泌所致。本研究是TOPCAT试验的二级分析,研究结果已发表于J Am Heart Assoc。

顽固性高血压可能是机体不适当的醛固酮分泌所致。本研究是TOPCAT试验的二级分析,研究结果已发表于J Am Heart Assoc。

研究纳入了有(n=1004)和无(n=2437)顽固性高血压的射血分数保留的心力衰竭(HFpEF)患者。顽固性高血压被定义为高血压患者的收缩压≥130毫米汞柱和/或舒张压≥80毫米汞柱,尽管同时使用肾素-血管紧张素系统阻断剂(血管紧张素转换酶抑制剂/血管紧张素受体阻断剂)、钙通道阻断剂和利尿剂;或作为那些使用≥4类降压药物的患者。主要结果是心血管疾病死亡、心脏骤停或心力衰竭住院的综合结果。分析螺内酯组结果的危险比(HRs)及95%的CIs,并使用Cox比例危险模型与安慰剂组进行比较。

 

结果显示,与安慰剂组相比,螺内酯组具有顽固性高血压的HFpEF患者的主要结局事件风险明显降低(HR,0.70;95%CI,0.53-0.91;P=0.009),而没有顽固性高血压的HFpEF患者的主要结局事件风险在两组之间没有显著差异(HR,1.00;95%CI,0.83-1.20;P=0.97)。螺内酯使用和顽固性高血压之间存在着明显的相互作用(P=0.03)。仅在来自美洲(美国、加拿大、巴西和阿根廷)的HFpEF患者中也观察到类似的关联。

综上,对于服用血管紧张素转换酶抑制剂/血管紧张素受体阻断剂、钙通道阻断剂和利尿剂的HFpEF患者,螺内酯可能是一种有效的附加药物。

 

原始出处:

 

Tetsuro Tsujimoto, Hiroshi Kajio. Spironolactone Use and Improved Outcomes in Patients With Heart Failure With Preserved Ejection Fraction With Resistant Hypertension. J Am Heart Assoc. 2020 Dec;9(23):e018827. doi: 10.1161/JAHA.120.018827.  

 

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content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210603/b2c0b965f17441e0a3e3d3183c10efd2/ba96cdef43d448e0942789db93c3d589.jpg, createdBy=e9c15503371, createdName=Kwok21w, createdTime=Fri Jun 11 16:12:15 CST 2021, time=2021-06-11, status=1, ipAttribution=)]
    2021-06-19 SR~young海东

    关注高血压,清淡饮食

    0

  5. 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content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210603/b2c0b965f17441e0a3e3d3183c10efd2/ba96cdef43d448e0942789db93c3d589.jpg, createdBy=e9c15503371, createdName=Kwok21w, createdTime=Fri Jun 11 16:12:15 CST 2021, time=2021-06-11, status=1, ipAttribution=)]
    2021-06-14 SR~young海东

    高血压,注意饮食

    0

  6. 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content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210603/b2c0b965f17441e0a3e3d3183c10efd2/ba96cdef43d448e0942789db93c3d589.jpg, createdBy=e9c15503371, createdName=Kwok21w, createdTime=Fri Jun 11 16:12:15 CST 2021, time=2021-06-11, status=1, ipAttribution=)]
    2021-06-12 zhaojie88
  7. 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    2021-06-12 slcumt
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    2021-06-11 Kwok21w

    0

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