BMJ:不同血压水平的糖尿病患者接受降压治疗的结果不同

2016-02-25 sunshine编译 MedSci原创

本研究旨在评估降压治疗对不同血压水平的糖尿病患者死亡率和心血管并发症的影响。

本研究旨在评估降压治疗对不同血压水平的糖尿病患者死亡率和心血管并发症的影响。

对随机对照试验进行系统评价和荟萃分析。研究人员检索了CENTRAL,MEDLINE,EMBASE及BIOSIS数据库。纳入的随机对照试验,包括100名或以上的糖尿病患者,治疗12个月或以上,对比了抗高血压药和安慰剂,两种抗高血压药与一种安慰剂作对比,或不同的血压控制目标。

结果共纳入了49项试验,包括73738名参与者。大多数参与者患有2型糖尿病。荟萃分析后发现,如果基线时期收缩压大于150 mm Hg,降压治疗则可降低患者的全因死亡率、心血管死亡率、心肌梗死、中风和终末期肾脏疾病的发生风险。如果基线时期收缩压为140-150 mm Hg,则降压治疗可降低患者的全因死亡率、心肌梗死和心脏衰竭的发生风险。如果基线收缩压低于140 mm Hg,降压治疗则会增加患者心血管疾病死亡的发生风险,还存在增加患者全因死亡率发生风险的趋势。回归分析表明,基线时期收缩压较低的患者接受降压治疗会增加其心血管疾病的死亡率和心肌梗死的发生风险。研究中患者接受抗压治疗的方式相似。

总而言之,对于收缩压 ≥ 140 mm Hg糖尿病患者来说,降压治疗可降低其死亡率和心血管并发症的发生风险。但是,如果收缩压<140 mm Hg,则进一步的降压治疗可增加患者的心血管死亡发生风险,且未观察到其他的益处。

原始出处:

Mattias Brunström, Bo Carlberg, Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses. BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i717 (Published 25 February 2016)Cite this as: BMJ 2016;352:i717.

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    2016-06-23 gaoxiaoe
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    2016-03-01 破风4392

    积分呢?

    0

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