在长期护理居民中处方抗高血压药物和心血管事件
Michelle C Odden1,2, Laura A Graham3, Xiaojuan Liu2
1Geriatric Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California.
JAMA network open
|November 25, 2024
概括
长期护理居民处方抗高血压药物并没有增加因心肌梗塞 (MI) 或中风住院的风险. 这一发现为考虑减少药物使用的临床医生和住院人员提供了有价值的信息.
科学领域:
- 老年学是一门学科.
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 处方抗高血压药物在长期护理中很常见,但其对心血管事件的影响尚不清楚.
- 了解与抑郁症相关的风险对于患者安全和有效的药物管理至关重要.
研究的目的:
- 为了比较因心肌梗塞 (MI) 或中风住院的发生率,在接受抗高血压药物减压治疗和继续治疗的长期护理居民之间.
主要方法:
- 利用了目标试验模拟与来自美国退伍军人事务部社区生活中心的观察电子健康记录数据.
- 包括65岁以上的长期护理居民服用抗高血压药物,分析干预后长达2年的结果.
- 使用治疗和审查权重的逆概率 (IPTW/IPCW) 进行每协议效果估计.
主要成果:
- 在13096名长期护理居民中,降低抗高血压药物的处方发生在17.8%的患者中.
- 在抑郁症和非抑郁症组 (HR,0.93;95% CI,0.70-1.26) 之间,在2年内,没有观察到MI或中风住院累积发病率的显著差异.
- 在应用IPTW和IPCW后,参与者的特征得到了很好的平衡,这表明了 robust 分析.
结论:
- 长期护理居民处方抗高血压药物与因心脏病发作或中风住院的风险增加无关.
- 这些发现提供了证据,以告知临床决策关于抗高血压药物在这个人群中降低处方.
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