在VA中使用 thiazide 利尿剂
1West Palm Beach Veterans Affairs Healthcare System, Florida.
概括
甲 (HCTZ) 仍然是VA中最常被处方的甲尿剂,尽管指南建议使用chlorthalidone. 甲的处方从2016年到2021年显著增加.
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:
- 2017年ACC/AHA高血压指南将chlorthalidone指定为首选的 thiazide 利尿剂.
- 了解美国退伍军人事务部 (VA) 当前的提亚齐德处方模式对于遵守指南至关重要.
研究的目的:
- 分析从2016年到2022年在VA内提亚类利尿剂处方趋势.
- 为了比较使用率,血压控制和补充模式在甲 (HCTZ),chlorthalidone和indapamide之间.
主要方法:
- 从2016年1月到2022年1月,对628994种活性 thiazide 处方 (HCTZ,chlorthalidone,indapamide) 的回顾性分析.
- 统计分析 (基平方测试与邦费罗尼校正) 确定利用率和比较结果.
- 同时补充/和血压控制率的评估.
主要成果:
- 甲 (HCTZ) 是使用最多的甲 (84.6%),其次是甲 (14.9%) 和英达巴胺 (0.5%).
- HCTZ使用率从90.2%下降到83.5%,而甲基使用率从9.3%增加到16.0% (P<0.001两种趋势).
- 在 thiazide 组之间没有观察到血压控制率的显著差异 (P = .58),但补充率有显著差异 (P < .001).
结论:
- 甲 (HCTZ) 仍然是VA处方的主要甲利剂,尽管有指导方针支持chlorthalidone.
- 在2016年至2021年期间,观察到甲处方的显著上升趋势.
- 这些发现凸显了需要策略来促进指导方针推的甲治疗.
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