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多中心伊斯拉迪尿动脉样硬化研究 (MIDAS) 的最终结论结果. 一个随机对照试验
N O Borhani1, M Mercuri, P A Borhani
1Department of Internal Medicine, School of Medicine, University of California at Davis, USA.
JAMA
|September 11, 1996
概括
这项研究发现,在伊斯拉迪平和甲之间,动脉内心-中枢厚度的进展没有差异. 然而,伊斯拉迪平与较高的血管事件发生率有关,需要进一步调查.
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.
- 医疗成像医学成像
背景情况:
- 高血压管理对于预防心血管疾病至关重要.
- 动脉内心-中枢厚度 (IMT) 是动脉样硬化的标志物.
- 对比不同抗高血压药物对动脉样硬化进展的影响是必不可少的.
研究的目的:
- 为了比较isradipine和hydrochlorothiazide之间动脉IMT进展的速度.
- 评估这些抗高血压药物治疗的患者血管事件的发生率.
主要方法:
- 随机,双盲,积极控制试验,涉及883名高血压患者.
- 定量B模式超声成像测量3年内平均最大IMT.
- 患者每天两次接受伊斯拉迪平或基亚胺.
主要成果:
- 在伊斯拉迪平和化胺之间没有观察到平均最大IMT进展率的显著差异 (P=.68).
- 与水甲治疗相比,伊斯拉迪平治疗与重大血管事件 (5.65% vs 3.17%) 和非重大血管事件/手术 (9.05% vs 5.22%) 的发病率较高 (P=0.07和P=0.02).
- 虽然这两种药物都降低了血压,但系统血压的差异无法解释isradipine增加的血管事件.
结论:
- 动脉IMT进展的替代终点在isradipine和hydrochlorothiazide之间没有区别.
- 在接受伊斯拉迪平治疗的患者中,血管事件的发生率增加是一个重大问题,需要进一步研究.
- 在这种患者群体中,甲酸可能是关于血管事件发生率的更安全选择.
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