定期的なアセトアミノフェンの使用と高血圧患者: PATH-BP試験
Iain M MacIntyre1, Emma J Turtle1, Tariq E Farrah2
1Department of Renal Medicine, Royal Infirmary of Edinburgh, National Health Service Lothian, UK (I.M.M., T.E.F.).
Circulation
|February 7, 2022
まとめ
定期的なアセトアミノフェンの使用は,高血圧患者の血圧 (BP) を著しく上昇させます. この発見は,この集団における慢性疼痛管理のためのアセトアミノフェンの日常的な使用に異議を唱えます.
科学分野:
- 心臓病科
- 薬理学について
- 臨床試験
背景:
- アセトアミノフェンは一般的なファーストラインの鎮痛剤で,しばしば血圧 (BP) に関するNSAIDよりも安全と考えられています.
- 観察研究はアセトアミノフェンと高血圧の間の潜在的な関連を示唆しているが,確固たる臨床試験データは欠けていた.
- アセトアミノフェンの安全性は,高血圧患者でも慢性疼痛の管理に広く使用されています.
研究 の 目的:
- 高血圧と診断された個体において,定期的なアセトアミノフェンの投与が血圧 (BP) に与える影響を調査する.
- アセトアミノフェンの血圧への影響に関する臨床試験の証拠を提供し,現在の医学知識のギャップを補う.
主な方法:
- ダブルブラインド,プラセボ対照のクロスオーバー研究が実施された.
- 110人の高血圧患者は,1日4回アセトアミノフェン1gまたはプラセボを2週間投与し,その後は2週間の洗い流し期間を受けた.
- 各治療段階の開始と終了時に24時間の出院式血圧モニタリングが行われました.
主要な成果:
- 定期的なアセトアミノフェンの摂取は,プラセボと比較して約4. 7mmHgの平均昼間静脈血圧の有意な増加をもたらした (P< 0. 0001).
- アセトアミノフェンの使用では,約1. 6mmHgの平均昼間静脈血圧の有意な増加も観察された (P=0. 005).
- 24時間の診察室と診療室での血圧測定は,これらの発見を裏付けました.
結論:
- アセトアミノフェンを1日4g摂取すると,プラセボと比較して静脈動脈圧が著しく上昇します.
- 血圧の上昇は,この患者群でアセトアミノフェンの定期的な使用に伴う心血管疾患のリスクを懸念しています.
- 高血圧患者の慢性疼痛管理におけるレギュラーアセトアミノフェンの確立された安全性プロファイルに疑問を投げかけています.
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