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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Updated: Jul 12, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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老年女性心血管结果与抗高血压药物治疗之间的关联.

Sylvia Wassertheil-Smoller1, Bruce Psaty, Philip Greenland

  • 1Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. smoller@aecom.yu.edu

JAMA
|December 16, 2004
PubMed
概括

对于患有高血压的绝经后妇女来说,结合通道阻塞剂和利尿药物增加了心血管死亡风险,相比于与利尿药物的β阻塞剂相比. 利尿剂单一治疗被证明是预防心血管并发症的最安全方法.

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科学领域:

  • 心脏病学 心脏病学
  • 高血压管理 高血压管理
  • 药理学 药理学是指药理学的学科.

背景情况:

  • 利尿疗法对高血压有效,但许多患者需要多种药物类别来控制.
  • 两种药物抗高血压组合的比较风险和益处尚未得到充分证实.

研究的目的:

  • 预期评估高血压的绝经后妇女的心血管死亡率的差异,这些妇女接受了各种抗高血压药物类别的单独或组合治疗.
  • 在没有先前心血管疾病的妇女中确定高血压的最佳治疗策略.

主要方法:

  • 对妇女健康倡议观察研究队列的分析 (93,676名50-79岁的妇女).
  • 专注于30219名患有高血压但没有心血管疾病 (CVD) 史的女性,平均跟踪5.9年.
  • 检查了ACE抑制剂,β-阻断剂,通道阻断剂或利尿剂 (单疗或联合疗法) 的基线使用与心血管疾病死亡率,冠状动脉疾病和中风发生率之间的关系.

主要成果:

  • 单独使用通道阻断剂与比单独使用利尿剂更高的心血管疾病死亡风险有关.
  • 与利尿剂加β阻塞剂相比,利尿剂加通道阻塞剂的组合显示,心血管疾病死亡风险增加了85%.
  • 这种增加的风险在调整多个共同变量和倾向分数后仍然存在,并且在没有糖尿病的女性中更为明显.

结论:

  • 在患有高血压的绝经后妇女中,两种药物治疗方案,即通道阻断剂加上利尿剂,与比塔阻断剂加上利尿剂更高的心血管死亡风险有关.
  • ACE 抑制剂加上利尿剂的风险与β 阻断剂加上利尿剂的风险相似.
  • 在预防心血管疾病并发症方面,利剂单一治疗被发现与其他单一治疗相等或优于其他单一治疗.