β-阻断剂作为高血压的初始治疗方法
Charles S Wiysonge1, Lionel H Opie
1Centre for Evidence-Based Health Care, Stellenbosch University, Cape Town, South Africa.
JAMA
|November 7, 2013
概括
β抑制剂不会降低高血压的死亡率,但与安慰剂相比,提供适度的心血管事件减少. 其他药物类别,如通道阻断剂,提供更大的益处.
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.
- 高血压管理 高血压管理
背景情况:
- 高血压是心血管疾病的主要危险因素.
- 最初的药理治疗策略显著影响患者的治疗结果.
- 贝塔抑制剂一直是高血压管理的传统选择.
研究的目的:
- 评估β-阻断剂作为初始高血压治疗的疗效.
- 为了比较β抑制剂与安慰剂,无治疗以及其他抗高血压药物类别.
- 评估对所有原因死亡率和心血管事件的影响.
主要方法:
- 随机对照试验的系统审查和元分析.
- 包括比较β抑制剂与安慰剂,无治疗或其他抗高血压剂的试验.
- 关注报告全因死亡率和主要心血管事件的研究.
主要成果:
- 最初的β-阻断剂治疗没有显示任何原因死亡率的降低.
- 与安慰剂或没有治疗相比,观察到心血管事件的适度减少.
- 通道阻塞剂和RAS抑制剂表现出优异的心血管事件减少与β阻塞剂相比.
结论:
- 在初始高血压治疗中,β抑制剂与所有原因死亡率的降低无关.
- 虽然提供了一些心血管益处,但其他药物类别更有效.
- 目前的证据仅限于传统的β抑制剂,缺乏关于新药的数据.
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