Effect of Renin-Angiotensin system inhibition on cardiovascular events in older hypertensive patients with metabolic syndrome.
Effect of Renin-Angiotensin system inhibition on cardiovascular events in older hypertensive patients with metabolic syndrome.
复制标题
DOI：
10.1016/j.metabol.2013.11.006
复制
发表时间：
2014-03
影响因子：
9.8
通讯作者：
Cheang, Kai I.
中科院分区：
文献类型：
--
作者：
Zreikat, Hala H.;Harpe, Spencer E.;Slattum, Patricia W.;Mays, D'arcy P.;Essah, Paulina A.;Cheang, Kai I.
代谢综合征（MetS）与心血管疾病（CVD）相关。胰岛素抵抗已被假设为代谢综合征的潜在特征。血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）是广泛使用的抗高血压药物，可改善胰岛素敏感性。本研究的目的是评估ACEI/ARB对老年高血压合并代谢综合征患者发生心血管事件的影响。我们使用心血管健康研究，这是一项对年龄> 65岁的个体进行的前瞻性队列研究，以评估ACEI/ARB的使用和发生CVD事件（包括冠状动脉和脑血管事件）的时间。该研究包括777名患有高血压和ATP III定义的MetS，但基线时无CVD和糖尿病的受试者。考克斯回归模型用于评估ACEI/ARB与其他降压药相比对首次CVD事件发生时间的影响。ACEI/ARB的使用与CVD事件的风险降低相关（校正HR=0.658，95% CI）。[0.436-0.993]）。当单独评估CVD终点时，ACEI/ARB的使用与血管成形术和冠状动脉事件的发生率较低相关（HR分别为0.129和0.530，95%CI [0.017-0.952]和[0.321-0.875]）。ACEI/ARB的使用与伴有代谢综合征的老年高血压患者CVD事件风险降低相关，主要是由于冠状动脉事件减少。ACEI/ARB对老年代谢综合征患者心血管事件的潜在保护作用需要前瞻性研究进一步证实。
Metabolic syndrome (MetS) is associated with cardiovascular disease (CVD). Insulin resistance has been hypothesized as the underlying feature of MetS. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are widely used antihypertensives that may improve insulin sensitivity. The aim of the study is to evaluate the effect of ACEI/ARB on incident CVD events in older hypertensive patients with MetS. We used the Cardiovascular Health Study, a prospective cohort study of individuals > 65 years of age to evaluate ACEI/ARB use and time to CVD events (including coronary and cerebrovascular events). The study included 777 subjects who had hypertension and ATP III-defined MetS, but free of CVD and diabetes at baseline. Cox regression models were used to evaluate the effect of ACEI/ARB as compared to other antihypertensives on the time to the first CVD events. ACEI/ARB use was associated with a decreased risk of CVD events (adjusted HR=0.658, 95 % C.I. [0.436-0.993]) compared to other antihypertensives. When CVD endpoints were evaluated separately, use of ACEI/ARB was associated with lower rates of angioplasty and coronary events (HR of 0.129 and 0.530 respectively, with 95 % CI [0.017-0.952] and [0.321-0.875]). ACEI/ARB use was associated with a lower risk of CVD events in older hypertensive patients with MetS, primarily due to a reduction in coronary events. The potential protective effect of ACEI/ARB on CVD events in older individuals with MetS will need further confirmation from prospective studies.
登录
查看更多内容
影响因子：
37.8
作者：
Hunt, KJ;Resendez, RG;Stern, MP
通讯作者：
Stern, MP
影响因子：
16.2
作者：
McNeill, AM;Schmidt, MI;Heiss, G
通讯作者：
Heiss, G
DOI：
10.1111/j.1365-2362.1991.tb01405.x
发表时间：
1991-10-01
影响因子：
5.5
作者：
GANS, ROB;BILO, HJG;DONKER, AJM
通讯作者：
DONKER, AJM
影响因子：
4.8
作者：
LIND, L;POLLARE, T;LITHELL, H
通讯作者：
LITHELL, H
DOI：
10.4274/jcrpe.1020
发表时间：
2013-09-10
影响因子：
1.9
作者：
Bitkin EC;Boyraz M;Taşkın N;Akçay A;Ulucan K;Akyol MB;Akçay T
通讯作者：
Akçay T