在艾滋病毒感染的成年人中治疗高血压前期
Lily D Yan1,2, Vanessa Rouzier1,3, Rodney Sufra3
1Center for Global Health.
AIDS (London, England)
|January 6, 2025
概括
使用阿姆洛迪平治疗海地艾滋病毒感染者 (PWH) 的高血压前期治疗是有效和可行的. 这种干预措施在12个月内显著降低了血压和高血压的发生率.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 血压升高会增加艾滋病毒感染者心血管疾病的风险.
- 国际指导方针经常建议在高血压值 (≥140/90 mmHg) 开始高血压治疗,这可能会推迟患有高血压前期的PWH的治疗.
- 资源有限的环境在管理非传染性疾病方面面临着独特的挑战,例如PWH中高血压.
研究的目的:
- 确定治疗海地艾滋病毒感染者前高血压的有效性,可行性和可接受性.
- 评估阿姆洛迪平治疗对该人群降低血压和发生高血压的影响.
- 评估早期BP管理在资源贫乏的环境中的安全性和患者/提供者的接受度.
主要方法:
- 一个未盲目的随机临床试验,涉及海地250名艾滋病毒感染者和高血压前期的成年人.
- 参与者被随机分配给接受5毫克的阿姆洛迪平或不接受阿姆洛迪平,除非血压达到≥140/90毫米.
- 主要结局是12个月的随访期内静脉血压 (SBP) 的平均变化.
主要成果:
- 干预组在12个月后,与对照组相比,SBP (-5.9 mmHg) 和DBP (-5.5 mmHg) 的平均降低明显更大.
- 干预组中仅有5.6%的患者出现高血压事件,对照组的这一比例为23.0% (HR 0.18).
- 在病毒载量抑制或与药物相关的严重不良事件中没有观察到差异;干预的可接受性很高.
结论:
- 在资源贫困的环境中治疗艾滋病毒感染者的高血压前期是可行的,可以接受的和有效的.
- 早期使用安洛迪平的干预可以显著降低血压和PWH中高血压的发生率.
- 这些发现支持在低收入国家对PWH高血压管理的治疗指南进行修订.
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