演变黑人种族在高血压治疗中的作用
John M Flack1, Stephanie Bitner1, Michael Buhnerkempe2
1Hypertension Section, Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of Medicine, Springfield IL, USA.
American journal of hypertension
|July 18, 2024
概括
基于种族的高血压药物选择是无效的. 使用强烈治疗和生活方式改变的种族不可知方法改善了黑人患者的血压控制.
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:
- 从历史上看,黑人患者的抗高血压药物选择一直以种族为指导,偏好 thiazide 利尿剂和抗体而不是 氨酸-血管新生素系统 (RAS) 抑制剂.
- 目前的处方模式反映了这一点,与白人患者相比,黑人患者使用推类的更高,使用RAS抑制剂的更低.
- 尽管联合治疗的使用越来越多,但高血压控制率在黑人患者中滞后.
研究的目的:
- 评估一种种族不可知治疗算法的有效性,以对黑人患者的高血压管理.
- 挑战传统的基于种族的抗高血压药物选择方法.
- 强调密集治疗和生活方式修改的作用.
主要方法:
- 审查当前的抗高血压药物处方模式和跨种族群体的高血压控制率.
- 对不同药物类别和组合的血压反应模式的分析.
- 检查一个全面的高血压控制程序,利用种族不可知的算法.
主要成果:
- 与白人患者相比,黑人患者的高血压控制率较低,即使使用组合疗法.
- 基于证据的组合疗法 (抗剂或 thiazide 利尿剂 + RAS 阻断剂) 在血压反应中没有已知的种族差异.
- 一种种族不可知的治疗算法在黑人和白人患者中实现了超过80%的高血压控制,种族差异最小.
结论:
- 种族不是选择有效的抗高血压药物治疗的必要或足够因素.
- 强化,种族无关的药物治疗,结合强烈强调饮食和生活方式的修改,建议在黑人患者中进行最佳的高血压管理.
- 转向种族不可知主义策略对于改善高血压控制和减少种族差异至关重要.
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