在REQUIRE试验中对抗高血压药物的坚持:临时后探索性评估
Kazuomi Kario1, Hisashi Kai2, Shinsuke Nanto3
1Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. kkario@jichi.ac.jp.
概括
药物坚持显著影响耐性高血压 (RH) 治疗结果. 在REQUIRE试验中不良的依从性使得结果变得混乱,突出了未来RH研究中需要监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床试验 临床试验
背景情况:
- 药物坚持对于管理高血压至关重要,特别是耐药高血压 (RH).
- 变量坚持可以显著混临床试验评估抗高血压疗法的结果.
- 该REQUIRE试验调查了在RH患者中的超声波损伤 (uRDN) 与虚假损伤.
研究的目的:
- 评估基线和改变药物坚持对REQUIRE试验中血压结果的影响.
- 为了比较RRDN与假药在RH患者的疗效,RH患者的坚持水平各不相同.
主要方法:
- 对REQUIRE试验数据的后期分析.
- 在基线和3个月使用尿样评估药物坚持.
- 基于坚持的RRDN和假装组之间的24小时门诊系统血压 (ASBP) 变化的比较.
主要成果:
- 45%的RH患者在基线时表现出不良的坚持.
- 在具有良好的基线坚持的患者中,urDN导致ASBP降低,而假药没有.
- 与RRDN患者不同的是,不良附着的假患者显示出更好的附着性和显著的ASBP减少,与RRDN患者不同.
结论:
- 缺乏坚持的假患者的坚持变化可能解释了REQUIRE试验中缺乏显著的群体间差异.
- 监测和确保药物坚持对于未来对抗性高血压的干预研究至关重要.
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