心血管药物治疗中的性别差异:虚构还是事实? . . . . . . . . . . . . . . 这是一个很好的时刻. 为什么我们看不到证据?
1Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain.
European heart journal. Cardiovascular pharmacotherapy
|August 4, 2025
概括
与性别相关的差异影响心血管药物疗效和安全性,但女性在试验中代表性不足. 对个性化的心血管药物治疗需要更多的研究.
科学领域:
- 心血管药理学心血管药理学
- 医学中的性别相关差异.
- 精确的药物疗法精确的药物疗法.
背景情况:
- 与性别相关的差异 (SRD) 影响药物的药理动力学,疗效,安全性和剂量,特别是对于心血管药物.
- 从历史上看,女性在临床试验中代表性不足,导致SRD在心血管药物有效性和安全性方面的数据稀缺.
- 临床实践指南往往缺乏按性别分类的数据,尽管有潜在的SRD,但建议男性和女性进行类似的治疗.
研究的目的:
- 分析关于SRD在心血管药物有效性,安全性和剂量方面的有限信息的原因和后果.
- 评估目前女性心血管药物剂量的适当性.
- 识别性别之间使用指南推的心血管药物 (CPGRD) 的差异,并从性别特定的角度提出改善心血管疾病预防和治疗的建议.
主要方法:
- 关于心血管药物治疗中与性别相关的差异现有文献的叙事综述.
- 对随机临床试验 (RCT) 关于性别分类报告的数据的分析.
- 对心血管药物治疗中的性别特定建议的临床实践准则 (CPG) 的评估.
主要成果:
- 关于心血管药物疗效,安全性和剂量的SRD存在有限的数据,阻碍了个性化药物治疗.
- 女性不太可能接受指导方针推的心血管药物,并且可能会出现更多的不良药物反应.
- 通常,RCT在检测SRD方面的能力不足,导致CPG无法充分解决性别特异性需求.
结论:
- 对于理解心血管药物反应中SRD背后的机制至关重要,以便开发个性化的治疗方法.
- 目前的临床实践和指导方针需要修订,以纳入性别特异性考虑,以改善心血管疾病 (CVD) 的预防和治疗.
- 未来的研究和临床试验设计必须优先考虑按性别分类的数据收集和分析,以解决心血管药物治疗方面的知识差距.
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