拉米普里尔与安洛迪平对高血压硬化的结局的影响:一项随机对照试验
L Y Agodoa1, L Appel, G L Bakris
1Case Western Reserve University, Clinical Hypertension Program, University Hospitals of Cleveland and the Louis Stokes Cleveland Veterans Affairs Medical Center, 10900 Euclid Ave, Wood Bldg Room W-165, Cleveland, OH 44106-4982, USA. jxw20@po.cwru.edu
JAMA
|June 21, 2001
概括
拉米普利在高血压患者中与蛋白尿症相比,拉米普利显著减缓了功能下降,而安洛迪平相比,它显著减缓了功能下降. 这种ACE抑制剂也可能有利于没有蛋白尿症的患者,为预防功能衰竭提供了一种新的策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血压诱导的末期病正在上升,特别是在非洲裔美国人中.
- 预防功能衰竭的最佳抗高血压策略尚不清楚.
研究的目的:
- 为了比较拉米普利尔 (ACE抑制剂),阿姆洛迪平 (通道阻断剂) 和美托普罗罗尔 (β阻断剂) 在管理高血压病进展方面的疗效.
主要方法:
- 一项随机双盲试验的临时分析,该试验涉及1094名患有高血压脏疾病的非裔美国人.
- 比较侧重于拉米普利尔与安洛迪平组,评估膜过率 (GFR) 和临床终点的变化.
主要成果:
- 在蛋白尿症患者中,拉米普里尔显著减缓了36%的GFR下降,并将临床终点风险降低了48%,与安洛迪平相比.
- 虽然在整个队列中没有看到GFR下降的总体差异,但在调整后的分析中,拉米普利尔显示临床终点风险降低,蛋白尿减少.
结论:
- 拉米普利尔可以延缓蛋白尿症高血压患者的病进展.
- 拉米普利尔可能对没有蛋白尿症的患者有好处,这表明它在预防高血压脏疾病进展方面的潜在作用.
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