Hypertension:老年体弱患者降压治疗效果

2020-06-08 MedSci原创 MedSci原创

近日,心血管权威杂志Hypertension上发表了一篇研究文章,该研究旨在评估体弱老年患者与非体弱老年患者降压药依从性与死亡风险之间的关系。

近日,血管权威杂志Hypertension上发表了一篇研究文章,该研究旨在评估体弱老年患者与非体弱老年患者降压药依从性与死亡风险之间的关系。

研究人员使用意大利伦巴第大区的数据库,确定了1283602名≥65岁(平均年龄为76岁)的居民,他们在2011年至2012年期间服用3种以上降压药。该研究采用嵌套病例对照设计,病例为在观察期(7年)内死亡的队列成员。Logistic回归用于对感兴趣的关联进行建模,并对潜在的混杂因素进行调整。通过按处方服药时间比例来衡量患者依从性,并对良好、中度、较差的和非常差的临床状态患者分别进行分析,该评分被证明是敏感的意大利人群死亡预测因子。

7年死亡率从16%(良好)上升到64%(非常差)的临床状态。与降压治疗依从性极低(按处方服药时间<25%)患者相比,依从性较高(按处方服药时间>75%)患者在各组中的全因死亡风险较低,从良好状态到极差状态的差异逐渐减小(-44%、-43%、-40%和-33%)。

由此可见,降压药的依从性与较低的血管疾病死亡率相关。高血压患者依从性似乎对年老体弱患者具有保护作用,但与临床状态良好的患者相比,其获益并不明显。

原始出处:

Federico Rea.et al.Antihypertensive Treatment in Elderly Frail Patients Evidence From a Large Italian Database.Hypertension.2020.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.14860

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    2020-06-30 feather89
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    2020-06-08 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2020-06-08 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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Stroke:急性卒中后启用降压治疗的时机和血压目标

高血压是卒中复发的重要危险因素。因此,在卒中二级预防中降压药物扮演着重要作用。

培哚普利/吲达帕胺固定剂量复方制剂降压治疗中国专家共识

培哚普利/吲达帕胺联合治疗在我国人群中进行过多项大样本的临床试验,其中降压降糖治疗2型糖尿病预防血管事件研究(ADVANCE)使用培哚普利/吲达帕胺FDC,结果显示,培哚普利/吲达帕胺FDC可有效控制血压,显著降低心脑肾事件和死亡风险,耐受性良好。 上述研究为培哚普利/吲达帕胺FDC在中国人群中的应用提供了直接的临床试验证据。为进一步推广其合理应用,促进我国血压控制率的提升,在专家委员会复习讨论的

Hypertension:动态血压监测差异大,提示患者降压治疗不依从

临床动态血压监测数据受患者、设备相关因素及临床血压测量不足的影响。近期发表于Hypertension的一项研究评估了降压治疗依从性的预测因素。 在DENERHTN试验(高血压肾神经阻断)的事后分析中,研究人员希望评估降压治疗不依从对动态血压的影响。从106例具有顽固性高血压表现的患者中筛选出77例,均符合接受标准化降压治疗且标准化三药治疗1个月后作为基线数值和治疗6个月后的平均血压和药物筛选

Stroke:急性缺血性脑卒中后白质高密度、降压治疗与功能结局

高WMH负荷的参与者在急性缺血性卒中后死亡或严重残疾的风险增加。早期抗高血压治疗对各种WMH严重程度的急性缺血性脑卒中患者临床结局的影响呈中性。

BMJ:社区血压筛查对中国老年人群产生积极影响

研究发现,以社区为基础的高血压筛查和鼓励血压升高的人寻求治疗和采取降压行为的改变,对收缩压产生重要且积极的长期影响。

AHA中国之声:降压治疗的收缩压轨迹与心血管疾病风险:不同试验中的相似模式

11月16~18日,由美国心脏协会(AHA)主办的2019科学年会在美国费城召开。中山大学附属第一医院心血管内科庄晓东博士在大会上汇报了《Data-driven Trajectories of On-treatment Systolic Blood Pressure and Cardiovascular Risk in SPRINT and ACCORD:Similar Pattern in Di