根据需要的血压药物和VA医院的不良结果
Muna Thalji Canales1,2, Seonkyeong Yang3,4, Anders Westanmo5
1Medical Service, Research Service and Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida.
JAMA internal medicine
|November 25, 2024
概括
在接受必要药物治疗的住院退伍军人中,无症状血压升高显示急性损伤 (AKI) 风险增加. 需要进一步的试验来证实这些发现并指导治疗策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 住院患者经常有无症状的血压升高.
- 根据需要 (PRN) 的血压药物通常用于这些升高.
- 退伍军人是一个易受血压迅速下降的缺血事件的人群,但PRNBP药物的影响尚不清楚.
研究的目的:
- 评估急性损伤 (AKI) 和与住院退伍军人服用PRN血压药物相关的其他不良结果的风险.
主要方法:
- 使用目标试验仿真和倾向性得分匹配的回顾性队列研究.
- 包括2015-2020年间在非ICU楼层住院≥3天的成年退伍军人.
- 主要结局:到第一个AKI的时间;次要结局:快速降低血压,心脏病,中风或死亡的组合.
主要成果:
- 分析了133760名退伍军人;21%的人接受了PRNBP药物.
- 使用PRNBP药物与增加AKI风险有关 (aHR,1.23).
- PRN使用者有更高的快速血压降低 (1.5倍) 和复合结果 (1.69倍) 的风险.
结论:
- 在住院退伍军人中使用PRN血压药物与AKI的风险更高有关.
- 亚组分析表明,静脉注射PRN药物的风险增加.
- 建议进行前性试验,以确定风险和益处.
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