WONCA研究论文摘要汇编——病人用抗高血压药发生心房纤颤的风险:巢式病例对照研究

发布时间：2018-07-17 16:12

【摘要】：背景不同种类的抗高血药压可改变心房纤颤的风险。有些研究提出,使用某些干扰肾素-血管紧张素系统的药物可从其心房重构作用而受益。目的对不同抗高血压药病人发生心房纤颤相关风险做评估和对照。设计巢式病例对照研究。设施英国联合王国-全科医学研究数据库,初级保健数据库,含有近500万例病人记录。病人 682993例病人接受高血压治疗,4661例心房纤颤和18642例病人作为对照参试者。测量对血管紧张素转换酶抑制剂(ACEI)、血管紧张素II受体阻滞剂(ARBs)和β-阻滞剂使用者与参照组钙通道阻滞剂使用者发生心房纤颤风险做了对照。排除了有心房纤颤临床风险因素的病人。结果与长期单用钙通道阻滞剂(CCB)相比,长期单用ACE抑制剂[OR=0.75,95%CI(0.65,0.87)]、ARBs[OR=0.71,CI(0.57,0.89)]或β-阻滞剂[OR=0.78,CI(0.67,0.92)]发生心房纤颤风险要低。限度治疗过程未能观察血压变化,一项观察研究不能完全排除效果偏倚风险。结论与钙通道阻滞剂相比,高血压病人长期用ACE抑制剂、ARBs或β-阻滞剂使心房纤颤风险减少。
[Abstract]:Background different kinds of anti high blood pressure can change the risk of atrial fibrillation. Some studies suggest that some drugs that interfere with the renin angiotensin system can benefit from its atrial remodeling. Objective to evaluate and compare the risk of atrial fibrillation in patients with different antihypertensive drugs. A nested case control study was designed. The UK United Kingdom - general medical research database, primary health care database, containing nearly 5 million patient records. 682993 patients received hypertension, 4661 atrial fibrillation and 18642 patients as the control participants. The angiotensin converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARBs) and beta - beta were measured. The users of the blockers were compared with the reference group of calcium channel blockers in the reference group. Patients with atrial fibrillation clinical risk factors were excluded. The results were compared with the long-term single calcium channel blocker (CCB), a long-term single ACE inhibitor [OR=0.75,95%CI (0.65,0.87)], ARBs[OR=0.71, CI (0.57,0.89)] or beta blocker [OR=0.78, CI (0.67,0.92)] has a low risk of atrial fibrillation. No changes in blood pressure are observed in the limited treatment process. An observation study does not completely exclude the risk of effect bias. Conclusion compared with calcium channel blockers, patients with hypertension have long-term use of ACE inhibitors, ARBs or beta blockers to reduce the risk of atrial fibrillation.
【作者单位】：中国石油中心医院;
【分类号】：R544.1;R541.75

【相似文献】