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Eur Heart J：ACEI和ARB或降房颤风险

2014-01-14 高晓方 译 医学论坛网

ACEIARB房颤风险
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丹麦一项回顾性研究表明，与β阻滞剂和利尿剂相比，血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体拮抗剂（ARB）单一治疗基线水平无心衰的高血压患者、缺血性心脏病、糖尿病和甲亢患者与其房颤风险显著降低具有相关性。但与其他药物相比，上述两种药物并未降低卒中风险。论文于2013年12月17日在线发表于《欧洲心脏杂志》（Eur Heart J）。 研究者将无房颤的ACEI单

丹麦一项回顾性研究表明，与β阻滞剂和利尿剂相比，血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体拮抗剂（ARB）单一治疗基线水平无心衰的高血压患者、缺血性心脏病、糖尿病和甲亢患者与其房颤风险显著降低具有相关性。但与其他药物相比，上述两种药物并未降低卒中风险。论文于2013年12月17日在线发表于《欧洲心脏杂志》（Eur Heart J）。【原文下载】

研究者将无房颤的ACEI单药治疗者与β阻滞剂应用者、利尿剂应用者、钙通道拮抗剂应用者和ARB单药治疗者进行配对比较。此外，将ARB单药应用者与β阻滞剂应用者、利尿剂应用者、钙通道拮抗剂应用者和ACEI单药治疗者进行配对比较。受试者均无心衰、缺血性心脏病和糖尿病等易致房颤疾病。

结果显示，与β阻滞剂和利尿剂相比，ACEI可使房颤发病率分别降低88%和49%。与钙通道拮抗剂相比，ACEI治疗未能降低房颤发病率。与β阻滞剂和利尿剂相比，ARB可使房颤风险分别降低90%和57%。与钙通道拮抗剂相比，ARB亦未能降低房颤风险。与ACE抑制剂相比，ARB治疗使房颤风险减低32%。

研究者指出，所有的降压药均可能具有潜在的降房颤风险作用，但ACEI和ARB尤其是使患者获益明显，但至今有关这两种药对房颤的随机对照研究尚显示混杂的结果。

原文出处：

ACE Inhibitors, ARBs Lower AF Risk in Hypertension

Marott SC, Nielsen SF, Benn M, Nordestgaard BG.Antihypertensive treatment and risk of atrial fibrillation: a nationwide study. Eur Heart J 2014;DOI:10.1093/eurheartj/eht507.【原文下载】

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    2014-10-23 shanyongle

    #ACE#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1655691, encodeId=8d1016556912f, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Thu Oct 23 00:03:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6882, encodeId=0d8e6882af, content=这个研究只能提供参考价值，毕竟只是回顾性研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci特约评论员, createdTime=Fri Jan 17 23:53:00 CST 2014, time=2014-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355818, encodeId=2de7135581804, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531991, encodeId=0a0d153199167, content=<a href='/topic/show?id=b0885428229' target=_blank style='color:#2F92EE;'>#房颤风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54282, encryptionId=b0885428229, topicName=房颤风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ea612304943, createdName=whmdzju, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562202, encodeId=35e11562202c4, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=)]
    2014-01-17 MedSci特约评论员

    这个研究只能提供参考价值，毕竟只是回顾性研究。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1655691, encodeId=8d1016556912f, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Thu Oct 23 00:03:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6882, encodeId=0d8e6882af, content=这个研究只能提供参考价值，毕竟只是回顾性研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci特约评论员, createdTime=Fri Jan 17 23:53:00 CST 2014, time=2014-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355818, encodeId=2de7135581804, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531991, encodeId=0a0d153199167, content=<a href='/topic/show?id=b0885428229' target=_blank style='color:#2F92EE;'>#房颤风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54282, encryptionId=b0885428229, topicName=房颤风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ea612304943, createdName=whmdzju, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562202, encodeId=35e11562202c4, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=)]
    2014-01-16 zhaojie88

    #ART#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1655691, encodeId=8d1016556912f, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Thu Oct 23 00:03:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6882, encodeId=0d8e6882af, content=这个研究只能提供参考价值，毕竟只是回顾性研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci特约评论员, createdTime=Fri Jan 17 23:53:00 CST 2014, time=2014-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355818, encodeId=2de7135581804, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531991, encodeId=0a0d153199167, content=<a href='/topic/show?id=b0885428229' target=_blank style='color:#2F92EE;'>#房颤风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54282, encryptionId=b0885428229, topicName=房颤风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ea612304943, createdName=whmdzju, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562202, encodeId=35e11562202c4, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=)]
    2014-01-16 whmdzju

    #房颤风险#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1655691, encodeId=8d1016556912f, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Thu Oct 23 00:03:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6882, encodeId=0d8e6882af, content=这个研究只能提供参考价值，毕竟只是回顾性研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci特约评论员, createdTime=Fri Jan 17 23:53:00 CST 2014, time=2014-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355818, encodeId=2de7135581804, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531991, encodeId=0a0d153199167, content=<a href='/topic/show?id=b0885428229' target=_blank style='color:#2F92EE;'>#房颤风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54282, encryptionId=b0885428229, topicName=房颤风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ea612304943, createdName=whmdzju, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562202, encodeId=35e11562202c4, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Jan 16 05:03:00 CST 2014, time=2014-01-16, status=1, ipAttribution=)]
    2014-01-16 爆笑小医

    #HEART#

    0

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认知功能正常或轻微认知功能障碍（MCI）患者，使用利尿剂、血管紧张素1受体阻滞剂（ARB）、血管紧张素转化酶抑制剂（ACEI）、钙通道阻滞剂（CCB）或β受体阻滞剂（BB）是否与阿尔茨海默病（AD）痴呆风险下降相关尚不清楚。为此，美国约翰斯霍普金斯大学SevilYasar等人进行了一项研究，研究结果在线发表在2013年8月2日的Neurology杂志上。研究结果提示：利尿剂、ARB和ACEI的应用