对抗高血压药物对精神分裂症发生的影响的比较估计:一项跨国观察队列研究
Dong Yun Lee1, Chungsoo Kim2, Jiwoo Kim3
1Department of Biomedical Informatics, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea.
BMC psychiatry
|February 16, 2024
概括
抗高血压药物,如ACE抑制剂,ARB, thiazide利尿剂,在整体精神分裂症风险上没有显著差异. 然而,在一项大型队列研究中,与ARB相比,ACE抑制剂的风险较高.
科学领域:
- 药物监督 药物监督 药物监督
- 精神病学流行病学 精神病学流行病学
- 心血管医学 心血管医学
背景情况:
- 关于抗高血压药物对随后精神分裂症风险的影响的证据有限.
- 需要进行大规模的观测研究来澄清这种关联.
- 这项研究调查了使用不同一线抗高血压药物的患者中精神分裂症风险.
研究的目的:
- 为了比较使用血管素转化酶 (ACE) 抑制剂与血管素受体阻断剂 (ARB) 或化尿剂的患者的精神分裂症风险.
- 来自美国和韩国的大型,基于索赔的队列中分析这种风险.
- 根据药物类别,研究精神分裂症风险的年龄特异性差异.
主要方法:
- 包括新诊断患有高血压的成年人 (≥18岁) 和处方ACE抑制剂,ARB或化尿剂.
- 使用大规模的倾向分数 (PS) 匹配来创建可比的队列.
- 主要终点是精神分裂症的发病率,根据年龄 (>45岁) 分析子组.
主要成果:
- 分析包括超过590万 (ACE抑制剂),290万 (ARBs) 和190万 (thiazide利尿剂) 的患者.
- 在ACE抑制剂与ACE抑制剂之间,没有发现精神分裂症风险的显著差异. ARBs (HR 1.15) 或 ACE 抑制剂与 thiazide 利尿剂 (HR 0.91) 相比.
- 与ARB相比,使用ACE抑制剂观察到精神分裂症的风险明显更高 (HR 1.23).
结论:
- 总的来说,在ACE抑制剂与ARB或 thiazide利尿剂之间,在精神分裂症风险上没有发现显著差异.
- 一个值得注意的发现是,与ARB相比,ACE抑制剂的精神分裂症风险明显更高.
- 建议进行进一步的研究,以阐明与抗高血压药物相关的精神分裂症风险,特别是在45岁以上的人群中.
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