在产后头2年使用抗高血压药物的模式
Frederikke Lihme1, Saima Basit1, Baskaran Thilaganathan2
1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
JAMA network open
|August 7, 2024
概括
患有妊娠高血压疾病 (HDP) 的女性通常需要产后抗高血压药物,发病时间因HDP的严重程度和先前药物使用而有所不同. 持续监测对于及时治疗和预防心血管疾病至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 妊娠高血压疾病 (HDP) 增加了分娩后慢性高血压的风险.
- 在有HDP病史的妇女中,产后高血压的管理不一致.
研究的目的:
- 评估在分娩后两年内开始服用抗高血压药物的发生率.
- 根据HDP状态和产前药物使用,分析这种发生率.
主要方法:
- 丹麦基于登记册的队列研究.
- 包括超过784,000名在1995-2018年间分娩的妇女.
- 分析了产后2年内开始使用抗高血压药物的情况.
主要成果:
- 开始产后抗高血压治疗的两年发生率从1.8% (没有HDP) 到44.1% (严重的孕前需要产前药物治疗).
- 大多数需要产后药物的妇女在HDP开始使用后3个月内 (75.1%-86.6%).
- 然而,显著的比例开始服用药物>3个月产后 (孕期高血压高达24.9%) 或>1年产后 (孕期高血压高达11.6%).
结论:
- 产后抗高血压药物的开始因HDP状态,严重程度和产前药物的使用而有很大差异.
- 显著的百分比的妇女在分娩后晚些时候开始治疗,突出了潜在的诊断延迟.
- 建议定期进行产后血压监测,以改善及时管理和预防心血管疾病.
相关概念视频
Antihypertensive Drugs: Direct Renin Inhibitors
517
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,...
517
Hormonal Regulation
33.0K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
33.0K
Antihypertensive Drugs: Types of β-Blockers
618
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
618
Adrenergic Antagonists: ɑ and β-Receptor Blockers
425
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
425
Factors Affecting Drug Response: Overview
1.9K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.9K
Antihypertensive Drugs: Angiotensin II Receptor Blockers
666
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
666


