英国初级医疗保健中高血压的第一线单一治疗和联合治疗趋势
Kyle Johnson1,2, Sarah Beradid2, James M Brophy1,3
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
British journal of clinical pharmacology
|September 13, 2025
概括
尽管有国际指导方针,但英国很少处方高血压的第一线联合治疗. 与组合疗法相比,单一疗法显示出更大的治疗持久性.
科学领域:
- 心血管医学 心血管医学
- 药物治疗 药物治疗
- 公共卫生 公共卫生
背景情况:
- 最佳的初始高血压治疗策略在全球范围内进行辩论.
- 英国的指导方针建议一线单一疗法,与大多数国际推支持组合治疗的建议形成鲜明对比.
- 英国初级保健处方模式的趋势对于初始抗高血压疗法的处方模式并不成熟.
研究的目的:
- 评估一线抗高血压单一治疗与联合治疗在英国初级保健中的开始趋势.
- 为了评估开始单一治疗或组合治疗的患者的治疗持久性.
主要方法:
- 2011-2019年使用临床实践研究数据链接 (CPRD) 的队列研究.
- 包括新诊断高血压的患者.
- 每年处方比例的计算和Kaplan-Meier估计治疗持续时间在6个月和1年.
主要成果:
- 在535,234名高血压患者中,只有1.7%接受了第一线联合治疗; 85.6%接受单一治疗.
- 联合治疗 (298天) 的中位治疗持续时间明显低于单一治疗 (398天).
- 一年后,46.4%的组合疗法发起者和51.2%的单一疗法发起者继续接受一线治疗.
结论:
- 第一线抗高血压组合疗法在英国初级保健中非常罕见,与NICE指南保持一致,但与国际规范有所不同.
- 与联合治疗相比,单一治疗在这个英国队列中表现出更高的治疗持久性.
- 这些发现突显了英国关于初始高血压管理的独特处方模式.
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