经常使用乙胺和高血压患者:PATH-BP试验
Iain M MacIntyre1, Emma J Turtle1, Tariq E Farrah2
1Department of Renal Medicine, Royal Infirmary of Edinburgh, National Health Service Lothian, UK (I.M.M., T.E.F.).
Circulation
|February 7, 2022
概括
在高血压患者中,定期使用乙氨基会显著增加血压 (BP),这与其被认为的安全性相反. 这一发现挑战了对该群体慢性疼痛的常规使用.
科学领域:
- 心脏病学
- 药理学
- 临床试验
背景情况:
- 乙氨基是一种常见的第一线止痛药,通常被认为比NSAID更安全.
- 观察性研究表明乙氨基与血压升高之间存在潜在联系,但缺乏可靠的临床试验数据.
- 乙氨基的安全性使其在治疗慢性疼痛方面得到广泛的应用,即使在高血压患者中也是如此.
研究的目的:
- 在被诊断患有高血压的个体中研究定期服用乙氨基对血压的影响.
- 提供关于乙氨基对血压的影响的临床试验证据,解决当前医学知识的差距.
主要方法:
- 使用双盲,安慰剂控制的交叉研究设计.
- 110名高血压患者被随机分配给每天四次服用1g乙氨基或安慰剂两周,然后进行两周的清洗期.
- 在每个治疗阶段开始和结束时进行24小时的门诊血压监测.
主要成果:
- 与安慰剂相比,定期服用乙氨基导致平均昼间静脉血压大约增加4. 7 mm Hg (P< 0. 0001).
- 在使用乙氨基时,也观察到白天大约1. 6mmHg的平均透气血压显著增加 (P=0. 005).
- 24小时的门诊和临床血压测量证实了这些发现.
结论:
- 与安慰剂相比,每天摄入4g的乙氨基可显著提高静脉压.
- 观察到的血压升高引起了人们对经常使用乙氨基的心血管风险的担忧.
- 这些发现质疑常用乙氨基在高血压患者的慢性疼痛治疗中的安全性.
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