在患有高血压的患者中,自我评价的药物坚持和不良心血管结果之间的关联
Shirin Ibrahim1, Nick S Nurmohamed1,2, Didier Collard1
1Department of Vascular Medicine, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands.
Journal of the American Heart Association
|November 10, 2023
概括
自我评估的药物坚持有效地识别了较低坚持的患者,将其与较差的血压控制,较高的LDL胆固醇以及心血管事件和死亡率的增加联系起来.
科学领域:
- 心血管医学 心血管医学
- 临床药房 临床药房
- 公共卫生 公共卫生
背景情况:
- 药物不服药是有效治疗的重要障碍,导致不良健康结果.
- 识别不服药症是一个临床挑战,影响患者管理和卫生系统的效率.
- 系统性血压干预试验 (SPRINT) 提供了一个独特的数据集来调查守.
研究的目的:
- 评估自我评价的药物坚持和关键健康指标之间的关联.
- 为了确定自我报告的坚持是否预测系统性血压 (SBP) 控制.
- 评估自我评价的坚持和低密度脂蛋白胆固醇 (LDL-C) 水平,心血管事件和全因死亡率之间的关系.
主要方法:
- 利用了9278名SPRINT参与者的数据,在3.8年内重复进行自我评估的坚持测量.
- 在0-100%的尺度上,定义较低的坚持率为≤80%的得分,高的坚持率为>80%.
- 采用SBP和LDL-C的线性混合效应回归,以及事件和死亡率的Cox比例危险模型.
主要成果:
- 在密集治疗和标准治疗臂中,较低的坚持与更高的治疗SBP显著相关.
- 粘附度较低的患者表现出较高的LDL-C水平 (估计增加11 mg/dL).
- 较低的坚持与心血管事件 (HR 1.69) 和全因死亡率 (HR 1.63) 的风险增加相关.
结论:
- 自我评价的药物坚持是识别低于最佳药物坚持的患者的实用工具.
- 自我报告的坚持与客观的临床结果有很强的相关性,包括血压控制和脂质水平.
- 通过自我评价来识别不坚持的患者可以帮助减轻心血管事件和死亡的风险.
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