抗高血压药物和老年人的湿疹性皮肤炎
Morgan Ye1, Leslie N Chan1, Ian Douglas2
1Department of Dermatology, University of California, San Francisco.
JAMA dermatology
|May 22, 2024
概括
抗高血压药物与老年人中湿疹性皮肤炎发病率略有增加有关. 利尿剂和通道阻断剂显示了最大的关联,而 ACE 抑制剂和β 阻断剂具有最小的关联.
科学领域:
- 皮肤病学 皮肤病学
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 在老年人中,医生诊断的湿疹率正在上升,对病因和治疗的了解有限.
- 初步证据表明,抗高血压药物可能会导致湿疹性皮肤炎.
- 对抗高血压药物对老年人湿疹的贡献的基于人口的数据很少.
研究的目的:
- 在60岁及以上的个体中调查抗高血压药物使用与湿疹性皮肤炎之间的关联.
主要方法:
- 一项纵向队列研究利用了英国1994年至2015年的初级保健数据.
- 包括1,561,358名没有先前诊断为湿疹的老年人.
- 分析了与抗高血压药物处方相关的新的湿疹性皮肤炎诊断.
主要成果:
- 湿疹性皮肤炎发生在6.7%的参与者中,在中位数为6年的随访期间.
- 服用抗高血压药物的人 (12/1000人/年) 的发病率高于非使用者 (9/1000人/年).
- 任何抗高血压药的使用都会使湿疹性皮肤炎的风险增加29% (HR, 1.29). 利尿剂 (HR, 1.21) 和通道阻断剂 (HR, 1.16) 的效果大小最大.
结论:
- 抗高血压药物的使用与老年人湿疹性皮肤炎率的适度增加有关.
- 利尿剂和通道阻断剂类别显示了最强的关联.
- 这些发现可能有助于临床医生在老年患者中治疗湿疹性皮肤炎.
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
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...
421
01:16Antihypertensive Drugs: Action of Diuretics
670
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
670
01:22Heart Failure Drugs: Diuretics
363
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
363
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
618
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...
618
01:25Antihypertensive Drugs: Direct Renin Inhibitors
597
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,...
597
01:23Antihypertensive Drugs: Vasodilators
505
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...
505