抗高血压药物类别和发生痴呆的风险:一项基于人口的跨国队列研究
Edmund C L Cheung1, Matthew Adesuyan2,3, Máté Szilcz4
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Age and ageing
|May 25, 2025
概括
与血管酶转化酶抑制剂 (ACEI) 相比,血管酶二受体抑制剂 (ARB) 可能会降低痴呆风险. 这项大型研究发现ARB与所有原因痴呆和血管痴呆的风险降低有关.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 像ACEI和ARB这样的抗高血压药物会影响血管素系统,可能会影响痴呆风险.
- 之前的研究表明,氨酸-血管增生素系统与认知能力下降之间存在联系.
研究的目的:
- 调查不同类型的抗高血压药物与痴呆症风险之间的关联.
- 在一个大型跨国队列中,比较ARB与ACEI的痴呆风险.
主要方法:
- 一项基于人口的跨国队列研究,利用来自香港,英国,瑞典和澳大利亚的电子健康数据库.
- 采用了主动比较器,新用户设计,调整了Cox比例危险模型和治疗权重的逆概率.
- 该研究比较了所有原因痴呆症,阿尔茨海默病 (AD) 和血管痴呆症 (VaD) 的风险.
主要成果:
- 这项研究包括超过190万名个人,平均随访时间为5.6至8.4年.
- 与ACEI相比,启动ARB与所有原因痴呆的风险降低有关 (HR:0.92,95%CI:0.89-0.94).
- ARB还显示血管痴呆的风险降低 (HR:0.87,95% CI:0.78-0.96),但没有阿尔茨海默病.
结论:
- 这是迄今为止对抗高血压药物类别和痴呆症风险的最大多国队列研究.
- 医生和患者应考虑与ACEI相比,ARBs可以降低所有原因和血管痴呆的潜在风险.
- 研究结果表明,ARB可能是担心痴呆风险的患者的有利选择.
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