对抗高血压药物的重量变化目标试验的模拟
Pi-I D Lin1, Sheryl L Rifas-Shiman1, Joshua Petimar1,2
1Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Journal of general internal medicine
|September 30, 2025
概括
在一线抗高血压药物之间,体重变化有所不同. 利西诺普里尔与减肥有关,而美托普罗罗罗尔和普拉诺洛尔可能会引起适度的体重增加. 当处方血压药物时,请考虑这些影响.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 体重增加是患者对抗高血压药物的常见问题.
- 关于在开始服用这些药物后预期体重变化的数据有限.
- 对这一结果进行比较有效性试验是不可行的.
研究的目的:
- 估计和比较与开始和坚持常见处方的一线抗高血压药物相关的平均体重变化.
- 模拟一个目标试验来评估体重变化结果.
- 为了分析单一治疗治疗的体重变化.
主要方法:
- 使用电子健康记录 (EHR) 的回顾性观察队列研究.
- 随访时间为24个月.
- 包括141,260名在2010年至2019年期间在美国8个卫生系统处方7种抗高血压药之一的患者.
- 使用反向概率权重与重复结果的边际结构模型来调整混.
主要成果:
- 利西诺普里尔与6个月,12个月和24个月的平均体重减轻有关 (-0.69公斤, -0.58公斤和-1.121公斤,分别).
- 与利西诺普利尔相比,化,洛萨坦,美托普罗罗尔和普拉诺洛尔与6个月后更大的体重变化有关.
- 在12个月后,梅托普罗罗洛和普罗兰诺洛的体重变化比利西诺普里尔更大.
结论:
- 对抗高血压药物之间观察到体重变化的小差异.
- 利西诺普里尔的使用与减肥有关.
- 梅托普罗洛尔和普拉诺洛尔与适度的体重增加有关,这表明临床医生在药物选择中考虑体重影响.
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