晚上血压药物管理和心血管事件:系统审查和元分析
Ricky D Turgeon1, Blair J MacDonald1, Scott R Garrison2
1Faculty of Pharmaceutical Sciences, University of British Columbia, British Columbia, Canada.
The Canadian journal of cardiology
|August 21, 2025
概括
与早晨服用药物相比,晚上服用血压药物并没有减少心血管事件. 这一元分析发现晚上给高血压患者没有显著的益处.
科学领域:
- 心脏病学
- 药理学
- 临床试验
背景情况:
- 关于降低心血管事件的最佳时间对抗高血压药物仍然存在争议.
- 现有的随机证据需要综合,以澄清晚上和早上用药的益处.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较晚上和早上服用抗高血压药物.
- 评估药物时间对主要心血管不良事件和其他临床结果的影响.
主要方法:
- 在MEDLINE,Embase和CENTRAL数据库中进行了全面的系统搜索.
- 包括5项涉及46,606名高血压成年人的RCT,随访时间中位数为5. 2年.
- 用随机效应模型对试验级数据进行了元分析,对偏差风险较低的试验进行了敏感性分析.
主要成果:
- 与早上服用相比,晚上服用抗高血压药物并没有显著减少主要心血管不良事件 (HR,0. 71;95% CI,0. 43 - 1. 16).
- 仅限于低风险偏差试验的分析也显示没有显著差异 (HR,0. 94;95% CI,0. 86-1. 03).
- 在整体分析中观察到高异质性 (I2=94%).
结论:
- 晚上服用高血压药物与早上服用相比,并没有减少心血管事件.
- 这些发现表明,目前的抗高血压治疗策略可能不会影响主要的心血管结果.
相关概念视频
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
124
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
124
Errors occurring during blood pressure monitoring
965
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
965
Factors affecting Blood pressure
4.6K
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
4.6K
Hypertension IV: Drug Therapy and Lifestyle Modifications
38
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
38
Hypertension V: Nursing Management
42
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
42
Hypertension and Regulation of Blood Pressure
3.1K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
3.1K


