在动脉高血压患者中与 thiazide 相关的低血症:全国性基于人口的队列研究
Soie Kwon1, Hasung Kim2, Jungkuk Lee2
1Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea.
Journal of evidence-based medicine
|April 3, 2024
概括
酸性利尿剂是一种常见的高血压治疗方法,增加了低血的风险. 尽管存在这种风险,但对高风险患者的谨慎使用可能会改善结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
背景情况:
- thiazides 是第一线的高血压治疗.
- 与 thiazide 相关的低血 (TAH) 会导致住院治疗.
- 对TAH的风险因素需要在不同人群中进行评估.
研究的目的:
- 在韩国人口中评估TAH和其他与药物相关的低血风险.
- 为了确定低血症发展的独立风险因素.
主要方法:
- 利用来自国家医疗保险共享服务的大数据 (1,943,345名成年人).
- 在 thiazide 用户和对照组 (2014-2016) 之间比较了低血量率.
- 用可克斯的比例危险模型来分析风险因素.
主要成果:
- thiazide 组的低血住院率较高 (2.19%与1.45%相比).
- 同时使用其他利尿剂或德斯莫普林增大了低血症的风险.
- 低血症的风险随着年龄,糖尿病,抑郁症和 thiazide 的使用而增加 (HR=1.436).
- thiazide 用户表现出更好的6年生存率,但更多的骨折和低血症.
结论:
- 化物使用与降血风险和并发症的增加有关.
- 使用 thiazide 不会增加死亡率,并可能改善预后.
- 建议在高风险患者中谨慎使用 thiazide 处方.
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