心血管保护和降低血压:一个元分析
J A Staessen1, J G Wang, L Thijs
1Studiecoördinatiecentrum, Hypertensie en Cardiovasculaire Revalidatie Eenheid, Departement Moleculair en Cardiovasculair Onderzoek, Katholieke Universiteit Leuven, Leuven, Belgium. jan.staessen@med.kuleuven.ac.be
Lancet (London, England)
|October 31, 2001
概括
抗高血压药物提供类似的心血管保护,主要是通过降低血压. 通道阻塞剂可能提供额外的中风预防益处. 所有药物都显示出可比的长期疗效和安全性.
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.
- 临床试验 临床试验
背景情况:
- 除了降血压效果之外,抗高血压药物提供的心血管保护的程度仍然不清楚.
- 调查药物特性或静脉压降低是否驱动高血压患者的心血管结果至关重要.
研究的目的:
- 为了确定抗高血压药物的药理性质或静脉压降低是否对心血管结果负责.
- 为了比较不同类型的抗高血压药物的心血管保护.
主要方法:
- 进行了对9项涉及62,605名高血压患者的随机试验的元分析.
- 对于实验与参考治疗,计算了聚合概率比率.
- 在27项试验 (136,124名患者) 的元回归分析中,研究了降血压与结果之间的关系.
主要成果:
- 与较旧的药物 (利尿剂,β-阻断剂) 相比,通道阻断剂和血管激素转化酶抑制剂显示出类似的整体心血管保护.
- 通道阻塞剂与中风风险 (13.5%) 的较大降低,心肌梗塞风险 (19.2%) 的较小降低有关.
- 超回归表明,达到的静脉压差异解释了在试验中观察到的几率比率.
结论:
- 血压控制对心血管健康至关重要.
- 所有的抗高血压药物类别都表现出类似的长期疗效和安全性.
- 通道阻断剂可能在预防中风方面提供特定的优势,而转化酶抑制剂和α阻断剂除了降低血压之外没有显示好处.
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