在不列颠哥伦比亚省使用抗高血压药物的趋势,2004-2019:一项描述性研究
Jason D Kim1, Anat Fisher2, Colin R Dormuth2
1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC jason.kim@ubc.ca.
CMAJ open
|August 1, 2023
概括
在不列颠哥伦比亚省,抗高血压药物的使用在2015年指南更新后最初下降,但后来增加, thiazide的使用显著下降. ангиотензинII受体阻断剂 (ARBs) 的停药率最低,而 thiazides 的更换或增加药物的风险更高.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 高血压的临床指南在2015年更新,降低了血压目标.
- 这些指导方针变化对抗高血压药物使用的实际影响仍然不清楚.
- 本研究描述了2004年至2019年不列颠哥伦比亚省的抗高血压药物使用趋势.
研究的目的:
- 分析使用抗高血压药物的流行和发病率的趋势.
- 为了比较不同类型的抗高血压药物中断和治疗修改风险.
主要方法:
- 对30至75岁的不列颠哥伦比亚省居民 (2004-2019) 的纵向研究.
- 对五大抗高血压药物类别的分析: thiazides, ACE 抑制剂, ARB,通道阻塞剂和β 阻塞剂.
- 精细灰色竞争性风险分析以估计停药和治疗转换/补充的细危险比率.
主要成果:
- 总体而言,抗高血压药物使用率在2014年之前下降,然后在2019年增加.
- 从2004年到2019年, thiazide 使用率显著下降,而其他类别的使用率增加.
- 与 ACE 抑制剂或 ARB 单疗法相比,使用 thiazide 单疗法的患者中断和切换/添加风险更高.
结论:
- 尽管指导方针更新和整体抗高血压治疗增加,但第一线 thiazide 使用量下降.
- 抗胰岛素II受体抑制剂 (ARBs) 单一治疗与最低的断药风险相关.
- 化物单一治疗与更高的治疗修改风险有关,需要进一步研究处方因素.
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