胺类药物对血压的影响
Magnus Chan1, Jocelyn Joy Chan1, James M Wright1
1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
The Cochrane database of systematic reviews
|March 28, 2025
概括
每天使用安非他胺会增加儿童和成人血压和心率. 这一系统性审查发现,由于不良影响,戒断率更高,这表明安非他胺处方可能存在心血管风险.
科学领域:
- 药理学和毒理学 药理学和毒理学
- 心血管医学 心血管医学
- 临床试验和证据综合
背景情况:
- 胺类药物通常用于注意力缺陷/多动障碍 (ADHD) 和其他疾病,也用于提高表现.
- 人们对日常使用安非他的长期心血管影响存在担忧,需要对现有证据进行全面审查.
- 两胺的治疗益处和潜在危害之间的平衡需要仔细评估,特别是在血压和心率方面.
研究的目的:
- 与安慰剂相比,量化每日安非他胺摄入量对儿科和成人群体的静缩和静缩血压的影响.
- 评估二次结果,包括心率变化和由于不良影响而取消研究的发生率.
- 提供关于安非他胺的心血管和安全概况的高确定性证据综合.
主要方法:
- 一个系统的审查和对56个随机对照试验 (RCTs) 的元分析,涉及10,583名参与者.
- 在主要数据库 (Cochrane高血压专用注册,CENTRAL,MEDLINE,Embase) 进行了搜索,没有语言或出版限制.
- 主要结局包括血压 (mmHg) 的变化,次要结局是心率 (每分钟跳动) 和由于不良影响而导致的退出,使用固定效应模型进行分析.
主要成果:
- 氨基胺药物显著增加了心压血压1.93 mmHg和心压血压1.84 mmHg (高确定性证据).
- 心率增加了每分钟3.71次,这也得到了高确定性证据的支持.
- 接受胺类药物的参与者因不良反应而退出药物的可能性是2.69倍,在一个月内绝对风险增加了4.3%.
结论:
- 每日口服安非他胺使用导致血压和心率在不同使用时间内持续增加.
- 副作用的风险增加需要仔细考虑与安非他命治疗相关的心血管风险.
- 未来的研究应该包括24小时的门诊血压监测,以更好地评估长期的心血管影响.
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