贝塔抑制剂的使用和骨折风险
Raymond G Schlienger1, Marius E Kraenzlin, Susan S Jick
1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital, Basel, Switzerland.
JAMA
|September 16, 2004
概括
单独或与 thiazide 利尿剂一起使用β 阻断剂与成人骨折风险较低有关. 这一发现表明,对高血压和骨质疏松症风险的老年患者有潜在的益处.
科学领域:
- 心血管药理学心血管药理学
- 骨的新陈代谢 骨的新陈代谢
- 老年医学 老年医学
背景情况:
- 动物研究表明,β-阻断剂propranolol可能促进骨的形成.
- 关于使用β-阻断剂和骨折风险的人类数据有限,有或没有 thiazides.
研究的目的:
- 调查β-阻断剂使用 (单独或与 thiazides) 与成人骨折风险降低之间的关联.
主要方法:
- 一项病例控制研究使用了英国通用实践研究数据库 (GPRD).
- 包括30601名病例患者 (30-79岁) 与事件骨折 (1993-1999) 和120819匹配的对照.
- 分析了与β阻塞剂和/或 thiazide 使用相关的骨折风险的概率比率.
主要成果:
- 目前使用β抑制剂只显示骨折风险降低 (OR,0.77;95% CI,0.72-0.83).
- 目前仅使用 thiazides 也显示风险降低 (OR,0.80; 95% CI,0.74-0.86).
- 当前联合使用β-阻断剂和 thiazides 证明了最低的风险 (OR,0.71; 95% CI,0.64-0.79).
结论:
- 目前使用β-阻断剂,独立或与 thiazides 相关,与骨折风险降低.
- 联合疗法可能有利于患有骨质疏松症风险的高血压老年患者.
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