在老年人中停用抗高血压药物
Danijela Gnjidic1, Aili V Langford1,2, Vanessa Jordan3
1Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
The Cochrane database of systematic reviews
|March 31, 2025
概括
在老年人中停止服用抗高血压药物,死亡率,住院或中风几乎没有差异. 然而,关于心肌梗塞和不良反应的证据非常不确定,可能会增加血压.
科学领域:
- 老年医学 老年医学
- 心血管药理学心血管药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 高血压是心血管事件和慢性病的主要危险因素.
- 抗高血压药物减少心血管疾病,但可以导致老年人不良药物反应和相互作用.
- 对于一些老年人来说,可以考虑停止服用抗高血压药物,以减少药物负担.
研究的目的:
- 评估在老年人中停用抗高血压药物的效果.
- 评估抗高血压药物戒断对心血管事件,死亡率和不良反应的影响.
主要方法:
- 包括6项随机对照试验 (RCT) 与1073名年龄在50岁及以上的参与者.
- 对抗高血压药物的完全停用或剂量减少与继续服用药物的比较.
- 主要结局:死亡率,心肌梗塞,药物不良反应. 二次结果:住院,中风,血压,跌倒,生活质量.
主要成果:
- 停止服用抗高血压药物在全因死亡率上几乎没有差异 (低确定性证据).
- 关于对心肌梗塞和药物/戒断不良反应的影响的证据非常不确定 (确定性证据非常低).
- 停止治疗可能会导致心压和腹压血压升高 (低确定性证据).
结论:
- 目前的证据表明,当老年人停止服用抗高血压药物时,死亡率,住院或中风几乎没有差异.
- 关于对心肌梗塞和不良反应的影响存在重大不确定性,可能会增加血压.
- 低到非常低的确定性证据限制了坚定的结论;未来的研究应该专注于脆弱的个体和临床重要结果.
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