对于心力衰竭患者的盐替代品建议可能会影响指导方针导向的医学疗法定位
Jean-Michel Tartière1, François Roubille2, Muriel Salvat3
1Hôpital Sainte Musse, CHITS, Toulon, France.
ESC heart failure
|May 24, 2024
概括
医疗保健专业人员建议13%的慢性心力衰竭患者使用盐替代剂 (saltSubs),但这与使用指导方针导向医学疗法 (GDMT) 的频率较低有关,特别是ACE抑制剂/ARB/ARNis.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 减少摄入量对于治疗慢性心力衰竭 (CHF) 至关重要.
- 卫生保健专业人员 (HCP) 越来越多地推盐替代品 (saltSubs),并由患者使用,但其安全性和对心血管疾病的影响尚不清楚.
- 盐Subs对指导方针导向医学疗法 (GDMT) 在CHF管理中的影响仍然未知.
研究的目的:
- 描述和估计卫生保健专家推的频率,以及患者/护理人员报告的法国盐的使用情况.
- 为了调查盐Sub医疗保健工作人员的建议和GDMTs在CHF患者的使用之间的关联.
主要方法:
- 一个全国性的,横截面的,使用问卷的流行病学研究.
- 收集了关于患者特征,盐的使用/建议以及GDMT (ACEis/ARBs/ARNis,MRAs,BBs) 的数据.
- 统计分析以确定盐Sub建议和GDMT使用之间的关联.
主要成果:
- 13%的医疗保健工作者推盐;17%的患者和22%的护理人员报告使用盐.
- 建议食用盐的患者最近因急性心力衰竭住院的可能性更高.
- 推盐的医疗保健工作者受试者更有可能推改变生活方式 (饮食,运动).
- SaltSub的建议与使用ACEi/ARB/ARNi的频率较低 (74%对82%) 和整体GDMTs (P=0.046) 相关.
- 在减少或保留喷射分数 (EF) 的患者中观察到ACEi/ARB/ARNi的处方不足.
- 在EF ≥40%的患者中,saltSub建议与较高的 thiazide 使用和较少使用低EF GDMT有关.
结论:
- 初步发现表明,盐对GDMT使用,特别是ACEi/ARB/ARNi在CHF管理中的潜在负面影响.
- 盐的可用性和推值得仔细考虑,以防止滥用和可能偏离基于证据的GDMT.
- 医疗保健专家和药剂师的明智指导对于消费者对于盐的使用在CHF中至关重要.
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