催眠的使用和失眠患者心血管疾病的风险
Yao Xie1, Shiyu Zhu1, Shuang Wu1
1Department of Cardiology, State Key Laboratory of Transvascular Implantation Devices, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310009, China.
European journal of preventive cardiology
|August 7, 2024
概括
在失眠的个体中使用二胺与心血管风险增加有关,包括心脏病和死亡. 然而,Z型药物在这个人群中没有显著的心血管危险.
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.
- 流行病学 流行病学
背景情况:
- 失眠影响了总人口的很大一部分.
- 催眠剂通常用于失眠,但它们的长期心血管安全性尚未完全理解.
- 了解与不同类型的催眠药相关的心血管风险对于患者管理至关重要.
研究的目的:
- 调查催眠剂使用与失眠患者心血管结果之间的关联.
- 在一个失眠队列中,区分奔类药物与Z药物的心血管风险.
- 为提供基于证据的指导,关于催眠药物的心血管安全.
主要方法:
- 一项使用英国生物银行 (UKB) 数据进行的倾向分数匹配队列研究.
- 使用了考克斯的比例危险模型和灵敏度分析 (IPTW,竞争风险,共享脆弱模型).
- 药物点孟德尔随机化 (MR) 分析评估了催眠药和心血管疾病治疗点之间的关联.
主要成果:
- 在14.3年的中位数随访期间,Z-meds与冠心病 (CHD),中风或心血管死亡率之间没有发现显著的关联.
- bensodiazepine 使用与心脏病,心力衰竭 (HF) 和心血管死亡率的风险增加有显著的关联.
- 敏感性分析和药物向MR分析证实了Z-meds的心血管安全性,并强调了对二类药物的担忧.
结论:
- 不同类型的催眠药在失眠患者中表现出与心血管事件的异质关联.
- 观察和遗传证据表明,使用二zepines可能会引起心血管安全问题.
- 在英国生物银行失眠患者中,Z-meds似乎对心血管健康是安全的.
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