一个随机的基因型指导的perindopril使用随机试验
Sang-Hak Lee1, Chan Joo Lee1, Yura Kang2
1Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine.
Journal of hypertension
|August 21, 2023
概括
使用NELL1变体的基因型导向治疗显著减少了服用ACE抑制剂的患者的咳. 这种个性化的方法改善了对高血压的药物选择,最大限度地减少了副作用,并增强了心血管方面的益处.
科学领域:
- 药物基因组学 药物基因组学
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
背景情况:
- ангиотензин转化酶抑制剂 (ACEI) 对于高血压管理至关重要,但通常会导致剂量限制性咳.
- 这种副作用限制了它们的临床效用和潜在的心血管益处.
- 需要个性化医疗方法来缓解ACEI诱导的咳.
研究的目的:
- 为了调查基因型导向的百度普利的使用是否可以减少高血压患者的药物相关咳.
- 评估NELL1变体数据在指导宁-血管素系统阻断剂选择中的有效性.
主要方法:
- 一项随机试验,涉及68名高血压患者 (20-79岁),被分配到基因定型或对照组.
- 基因型组使用NELL1 p.Arg382Trp和内基因型来指导治疗:candesartan用于高风险,perindopril用于低风险.
- 对照组在没有基因定型的情况下接受了印布里尔.
主要成果:
- 与对照组相比,基因型组的咳风险 (12.2% vs 33.3%) 和中度/严重咳风险 (2.4% vs 18.5%) 显著降低.
- 咳和中度/严重咳的危险比分分别为0.25 (P=0.017) 和0.12 (P=0.025).
- 所有组的不良事件率在所有组中都相似.
结论:
- 与传统治疗相比,基因型导向治疗显著降低了咳的发生率.
- 对于个性化氨酸-血管素系统阻断剂治疗,改善患者的治疗结果,NELL1变异数据非常有价值.
- 这一策略增强了抗高血压药物的安全和有效使用.
更多相关视频
09:38Generalized Psychophysiological Interaction PPI Analysis of Memory Related Connectivity in Individuals at Genetic Risk for Alzheimer's Disease
Published on: November 14, 2017
15.0K
08:15Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease
Published on: May 10, 2024
611
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
463
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
463
01:25Antihypertensive Drugs: Direct Renin Inhibitors
680
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
680
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
690
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
690
01:13Randomized Experiments
7.0K
The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Simple randomization
Simple...
7.0K
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
14
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
14
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
780
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
780