患者报告的抗高血压药物的变化原因:使用社交媒体进行的定量研究
Cristina Micale1,2, Su Golder3, Karen O'Connor4
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. cvm006@students.jefferson.edu.
Drug safety
|November 23, 2023
概括
社交媒体分析显示,肌肉骨和呼吸系统症状是患者停止服用ARB和ACEI等抗高血压药物的关键原因,突出了改善坚持的目标.
科学领域:
- 药物监督和药物流行病学
- 医疗保健中的社交媒体分析
- 心血管疾病管理管理
背景情况:
- 高血压是导致心脏病的全球主要原因,药物不服药构成了重大的公共卫生挑战.
- 评估药物不服药的传统方法受到成本,反应偏差和回忆问题的限制.
- 社交媒体平台提供了一种有价值,低成本的替代方案,用于收集患者对药物不服药的直接见解.
研究的目的:
- 通过分析患者生成的在线内容,调查停用血管激素受体抑制剂 (ARB) 和血管激素转化酶抑制剂 (ACEI) 的主要原因.
- 为了比较来自社交媒体的不良事件报告与官方监管数据 (FDA FAERS) 的抗高血压药物.
主要方法:
- 利用自然语言处理分类器从WebMD药物评论中提取治疗变化的原因.
- 手动审查和注释最近有关ARB和ACEI的帖子,重点关注药物变化的原因.
- 将提取的社交媒体数据与美国食品和药物管理局的不良事件报告系统 (FAERS) 数据库进行了比较.
主要成果:
- 对343,459个WebMD评论的分析确定了1867个提到ARB或ACEI变化的帖子;587个被手动审查.
- 在绝大多数帖子中,不良事件被列为改变药物的原因 (97%的ARB,91%的ACEI).
- 通常报告的不良事件包括ARB的肌肉骨/连接组织疾病 (例如,肌肉/关节疼痛) 和ACEI的呼吸系统疾病 (例如,咳),其患病率高于FDA数据.
结论:
- 肌肉骨和呼吸系统症状经常报告的不良影响导致停用ARB和ACEI.
- 针对这些特定不良症状的管理是改善高血压患者药物持续性的有希望的策略.
相关概念视频
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
656
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...
656
01:25Antihypertensive Drugs: Direct Renin Inhibitors
640
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,...
640
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
748
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...
748
01:17Antihypertensive Drugs: Action of β1 Blockers
454
β1-receptors are primarily located in the heart and kidneys. In cardiac myocytes, these receptors interact with neurotransmitters released by the sympathetic nervous system during heightened activity or danger. As a result, β1-receptors get activated, initiating a series of biochemical processes. Excessive activation of beta receptors due to chronic stress can abnormally increase heart rate and contractility, resulting in high blood pressure or hypertension. To counteract this,...
454
01:28Antihypertensive Drugs: Types of β-Blockers
698
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
698
01:23Antihypertensive Drugs: Vasodilators
538
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
538