通过四大类的交叉旋转来优化抗高血压治疗
J E Dickerson1, A D Hingorani, M J Ashby
1University of Cambridge, Clinical Pharmacology Unit, Addenbrooke's Hospital, UK.
Lancet (London, England)
|June 22, 1999
概括
高血压患者对不同血压药物的反应各不相同. 系统的药物轮换,就像拟议的"AB/CD"规则一样,可以优化基本高血压治疗的疗效.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床高血压研究 临床高血压研究
背景情况:
- 传统的抗高血压药物的比较使用平行组.
- 这项研究研究了年轻,未经治疗的高血压患者中四种主要抗高血压药物类别的交叉旋转.
研究的目的:
- 通过系统的药物轮换来评估单一治疗的响应率.
- 评估患者对不同类型抗高血压药物反应的个体变异性.
主要方法:
- 在56名高血压患者中,进行了血管激素转化酶 (ACE) 抑制剂,β-阻断剂,通道阻断剂和利尿剂的交叉旋转.
- 评估了个体药物反应的可重复性和药物类别之间的相关性.
- 治疗的成功是通过在轮换后达到目标血压 (<或=140/90 mm Hg) 的患者比例来衡量.
主要成果:
- 观察到患者对抗高血压药物的反应有显著的变化.
- 系统轮换使单一治疗的成功率从39%提高到73% (p=0.0001).
- 发现了对ACE抑制剂和β-阻断剂 (r=0.5),通道阻断剂和利尿剂 (r=0.6) 的反应之间的相关性.
结论:
- 基本高血压在药物反应中表现出明显的个体间变异性,可能是由于潜在的疾病异质性.
- 通过多种疗法进行系统轮换对于优化抗高血压治疗至关重要.
- 建议采用"AB/CD"规则,以缩短轮换,最初从两个相关对中的每一种药物中选择一种药物.
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