在患有高血压和反射失眠的患者中,抑郁症的目标
Antonella Groppelli1, Giulia Rivasi2, Artur Fedorowski3
1IRCCS Istituto Auxologico Italiano, Faint and Fall Research Centre, Department of Cardiology, S. Luca Hospital, Piazzale Brescia 20, 20149 Milano, Italy.
European journal of internal medicine
|May 24, 2024
概括
为了防止高血压患者有反射失眠的血压下降,目标是24小时内血压 (SBP) 增加12 mmHg,达到134 mmHg. 戒药对于实现这一目标比减少剂量更有效.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 临床药理学 临床药理学
背景情况:
- 高血压管理在老年患者与反射失眠是复杂的.
- 系统性血压 (SBP) 降低可能导致昏迷,需要调整治疗.
- 确定最佳的血压目标对于抑郁症至关重要.
研究的目的:
- 确定24小时SBP增加的目标,以最大限度地减少SBP降低高血压患者的反射失眠.
- 评估药物戒断与剂量减少在预防SBP下降方面的有效性.
主要方法:
- 40名高血压患者 (平均年龄为73.6岁) 患有反射失眠和SBP下降,接受了门诊血压监测 (ABPM).
- 建议患者停止或减少抗高血压药物治疗.
- 在3个月内进行了第二次ABPM,以评估SBP下降<90 mmHg和<100 mmHg.
主要成果:
- 在50%的患者中,24小时SBP升高12 mmHg (至134 mmHg) 与白天SBP下降<100 mmHg的消失有关.
- 实现这一目标的患者的低血压药物减少率更大 (67%vs19%) 和更高的戒断率 (62%vs29%).
- 戒断药物比减少剂量 (16/98药物) 更常见 (44/98药物).
结论:
- 将24小时SBP升至134mmHg,代表12mmHg的升高,是防止SBP下降的最佳目标.
- 为了实现目标SBP目标,完全戒药通常比减少剂量更有效.
- 这些发现指导了高血压老年患者的抑郁症策略,患者有反射失眠.
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