JAHA:美国卒中幸存者的农村居住和降压药物使用情况分析

2022-07-20 MedSci原创 MedSci原创

伴有高血压病史的农村居民和城市居民在卒中后使用降压药物的情况相当,但需要进一步研究确定城市居民使用这些药物趋势增加的原因。

美国农村居民高血压患病率增加程度相对较高,可能导致卒中复发的地理差异。在美国,农村/城市居民卒中后使用降压药物的信息十分有限。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在评估2005年至2019年期间美国农村与城市卒中幸存者的降压药物使用和生活方式特征,以及基于居住地的趋势。

在2005年至2019年期间的全国行为风险因素监测系统调查中,研究人员确定了患有高血压的美国卒中幸存者。研究人员确定了在此期间奇数年内,农村/城市居民的高血压受访者中所报告的抗高血压使用情况和生活方式特征(即体育活动、糖尿病胆固醇、体重指数和吸烟)的调查加权患病率,并使用单独的趋势分析来评估使用随时间的变化。调查加权logistic回归用于计算降压药物使用的未调整和调整(社会人口和生活方式因素)的比值比。

该研究纳入了82175名(36.4%的农村居民)受试者。农村居民与城市居民的生活方式特征相似,但农村居民的吸烟率较高。在未调整和调整分析中,农村和城市卒中幸存者使用降压药物的情况相似(两种人群>90%)。趋势分析显示,随着时间的推移,城市人群中使用降压药物的人数略有增加(P=0.033),但农村卒中幸存者则没有增加(P=0.587)。

该研究的结果表明,伴有高血压病史的农村居民和城市居民在卒中后使用降压药物的情况相当,但需要进一步研究确定城市居民使用这些药物趋势增加的原因。

原始出处:

Phoebe M. Tran.et al.Rural Residence and Antihypertensive Medication Use in US Stroke Survivors.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.122.026678

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    2022-07-22 zhaohui6731
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    2022-07-22 daviiliu
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    2022-07-20 医鸣惊人

    认真学习了

    0

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    2022-07-20 小夜夜

    不错不错

    0

相关威廉亚洲官网

JAMA Netw Open:长期使用降压药物与主动脉夹层患者晚期结局的关系

主动脉夹层(Aortic Dissection)是主动脉腔内的血液从主动脉内膜撕裂处进入主动脉中膜,使中膜分离,沿主动脉长轴方向扩展形成主动脉壁的真假两腔分离状态。

Heart:降压药物对长期血压的影响

这些研究结果表明,降压药物疗法对不同特征人群的降压效果平均长达4年。需要适当的治疗策略来维持实质性的长期降压效应。

Stroke:降压药物种类对脑小血管疾病的影响

在SPRINT-MIND试验的参与者中,血管紧张素转换酶抑制剂与较慢的WMH进展相关,而不依赖于血压控制和年龄。

BMJ:降压药物的特定不良事件风险

抗高血压药物治疗可导致部分轻度不良事件,如高钾血症、低血;同时也可导致急性肾损伤和晕厥等严重不良事件。对于肾功能不良或存在其他高风险因素患者,需谨慎选择降压药物

Translational Psychiatry: 降压药与精神障碍有关

选择AHT类别应考虑患者的精神病史,如果患者在接受AHT时出现精神障碍,应进行审查。AHT类别与精神障碍的发生率存在差异。ARBs最有利,β受体阻滞剂最少。ARBs明显的有益作用值得进一步研究。

Heart:降压药物对长期血压的影响:随机临床试验的个体水平数据分析

降压药物治疗对具有不同特征的人来说都能有效降低血压,平均可达4年。