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在血管新生调节剂使用者中, thiazides 和 dihydropyridines 的骨质疏松性骨折风险
Yang-Chi Lin1, Ping-Hao Chiang2, Jing-Yang Huang3,4
1Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan.
概括
与ACE抑制剂或ARB相结合的化物药物与DPH药物相比,具有较低的骨折风险. 这些骨保护的益处可能会降低在炎症多叶性人体病或使用二二类药物的患者.
科学领域:
- 药理学和骨健康 药理学和骨健康
- 心血管疾病管理管理
- 老年医学 老年医学
背景情况:
- 高血压的管理涉及到各种药物类别,包括 thiazides 和胺-血管酶-阿尔多斯特系统 (RAAS) 抑制剂.
- ангиотензин转化酶抑制剂 (ACEi) 和 ангиотензинII受体阻断剂 (ARB) 是RAAS抑制剂,具有潜在的骨保护作用.
- 基管阻断剂 (DHP) 是常用的抗高血压药物,但它们对骨健康的影响不太清楚.
研究的目的:
- 为了比较典型的骨质疏松性骨折 (TOPF) 的风险,高血压患者接受了 thiazides 加ACEi/ARB 治疗,而那些接受了 DHP 药物加ACEi/ARB 治疗的人.
- 与基于DHP的疗法相比,研究基于 thiazide 的抗高血压疗法的潜在骨保护益处.
主要方法:
- 使用来自TriNetX数据库的美国协作网络进行的回顾性队列研究 (2015年1月至2022年12月).
- 包括使用ACEi或ARB与 thiazide或 DHP 治疗的高血压患者.
- 进行了1:1倾向-得分匹配 (PSM),随后进行了Kaplan Meier分析,随访5年.
- 主要结局是复合典型骨质疏松性骨折 (TOPF);进行了亚组和异质性分析.
主要成果:
- 这项研究包括每组PSM后的54,240名患者,年龄相似,主要是白人.
- 与DHP-ACEi/ARB使用者相比, thiazide-ACEi/ARB使用者的TOPF风险明显较低 (HR=0.65,95%CI 0.61-0.70).
- 在ACEi和ARB使用者之间, thiazide的益处是一致的;然而,在炎症性多样性和二胺使用的患者中注意到异质性.
结论:
- 与DHP药物相比,当与ACEi或ARB相结合时,铁酸抗高血压药与典型骨质疏松性骨折的风险降低有关.
- 观察到的提亚类药物对骨的保护效益可能会在患有炎症性多样性人体病和使用二二类药物的患者中减弱.
- 这些发现强调了在选择抗高血压药物时考虑骨折风险的重要性,特别是在特定的患者亚组中.
关键词:
1,4-二二二二二二二二二ангиотензин受体对抗剂 抗生素受体对抗剂ангиотензин转化酶抑制剂 抑制剂通道阻塞剂 通道阻塞剂骨质疏松性骨折可能会导致骨折.提亚齐德斯 (Thiazides) 是一个修女.更多相关视频
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