在使用RAAS抑制剂的脆弱老年患者中探索高血症风险
Anna M J Heemels1, Nadine P P M Gadiot2, Angele P M Kerckhoffs1
1Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
Drugs & aging
|January 8, 2025
概括
这项研究发现,使用Renin-angiotensin-aldosterone系统抑制剂 (RAASi) 的老年人没有增加过血症风险. 这种人群中高卡血症的关键危险因素与一般人群中的危险因素相似.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 氨酸-氨酸-阿尔多斯特系统抑制剂 (RAASi) 对于心血管和脏疾病管理至关重要.
- RAASi的使用会带来高血症的风险,这种情况特别适用于老年,有多种并发症的虚弱患者.
- 在RAASi治疗的脆弱老年患者中识别高血症风险因素对于安全治疗至关重要.
研究的目的:
- 通过使用RAASi.调查虚弱的老年患者中高胆血症的患病率.
- 为了确定这种脆弱人群中高胆血症的特定危险因素.
- 确定虚弱本身是否是RAASi用户中高胆血症的独立风险因素.
主要方法:
- 一个单中心的横截面研究,对2023名年龄≥70岁的RAASi患者进行了使用,并提交给急诊室.
- 临床虚弱度尺度 (CFS) 的回顾性评估和高血症的定义是血清≥5.5 mmol/L.
- 后勤回归模型被用来确定高血症的危险因素.
主要成果:
- 超血病的总体患病率为4.3%,脆弱 (4.7%) 和非脆弱 (3.3%) 患者之间没有显著差异.
- 高血症与年龄较小,糖尿病,中度至严重的功能衰竭以及同时使用结剂或节约性尿剂有关.
- 没有发现脆弱性 (CFS ≥5) 和高血症之间有显著的关联.
结论:
- 在老年RAASi使用者向急诊室提交的RAASi患者中,脆弱性并不是高胆血症的独立风险因素.
- 没有其他显著风险因素的脆弱老年患者可以在适当时安全地使用RAASi治疗.
- 高血的标准风险因素,如功能受损和特定的并发药物,在这个人群中仍然是关键考虑因素.
更多相关视频
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
16.5K
07:27Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
10.2K
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
381
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
381
01:22Heart Failure Drugs: Diuretics
338
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
338
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
445
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
445
01:11Renal Failure: Dose Adjustments
62
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
62
01:25Antihypertensive Drugs: Direct Renin Inhibitors
484
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
484
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.2K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.2K