在患有慢性病和抗性高血压的患者中使用阿普罗西坦
Patrick Rossignol1,2, Martine Clozel3, Roland F Dreier3
1INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, INSERM Unit 1116, Centre Hospitalier Régional Universitaire de Nancy, F-CRIN INI-CRCT, Université de Lorraine, France (P.R.).
Hypertension (Dallas, Tex. : 1979)
|December 9, 2025
概括
在患有慢性病 (CKD) 和抗性高血压的患者中,阿普罗西坦有效降低血压,减少白蛋白尿症. 这种治疗在这个高危人群中显示出心血管和脏保护的前景.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血压和慢性病 (CKD) 密切相关,耐药高血压在CKD患者中很常见,难以管理.
- 患有CKD和耐药高血压的患者面临高发病率和死亡率风险,需要有效的治疗选择.
研究的目的:
- 评估阿普罗西坦在患有慢性病和耐药高血压的患者中的疗效和安全性.
- 评估阿布罗西坦对血压的影响,尿液中白蛋白与肌素的比率,以及整体安全性.
主要方法:
- 对参与者147名KDIGO高风险或非常高风险CKD的PRECISION研究进行了后期分析.
- 对阿普罗西坦 (12.5毫克和25毫克) 与安慰剂进行4周的评估,随后延长治疗和戒断阶段.
主要成果:
- 阿普罗西坦显著降低了办公室的缩血压 (高达 -16.6 mm Hg) 和夜间的门诊缩血压 (高达 -13.8 mm Hg).
- 观察到尿液中白蛋白与肌素的比率显著降低 (高达-59.6%),在继续治疗阿布罗西坦坦时保持.
- 阿普罗西坦被很好地容忍,或估计的球过率没有显著变化;外围胀是最常见的不良事件.
结论:
- 阿普罗西坦被证明有效降低血压,特别是夜间门诊血压,并显著减少慢性结核病患者抗性高血压的白蛋白尿症.
- 该药物耐受性良好,并可能为这一具有挑战性的患者群体提供显著的心血管和脏保护益处.
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
888
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
888
01:25Antihypertensive Drugs: Direct Renin Inhibitors
1.2K
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.2K
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
2.4K
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
2.4K
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
2.3K
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
2.3K
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
244
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
244
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
426
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
426