Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study.
Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study.
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DOI：
10.1136/bmj.d8190
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发表时间：
2012-01-12
期刊：
影响因子：
--
通讯作者：
Rodríguez LA
中科院分区：
文献类型：
--
作者：
Choi HK;Soriano LC;Zhang Y;Rodríguez LA
目的探讨降压药与高血压患者痛风风险的独立相关性。设计巢式病例对照研究。设置英国全科医生数据库，2000- 2007。所有痛风事件病例（n= 24768）在20-79岁的成年人中，随机抽样5万名匹配的对照组。主要结局指标：与使用抗高血压药物相关的痛风事件的相对风险。结果在调整了年龄、性别、体重指数、全科医生就诊、酒精摄入量、相关药物和合共病等因素后，高血压患者（n= 29138）目前使用降压药物与痛风发生率相关的多因素相对危险度分别为：钙通道阻滞剂0.87（95%可信区间0.82 ~ 0.93）、氯沙坦0.81（95%可信区间0.70 ~ 0.94）、利尿剂2.36（95%可信区间2.21 ~ 2.52）、β受体阻滞剂1.48（95%可信区间1.40 ~ 1.57）。血管紧张素转换酶抑制剂为1.24(1.17 - 1.32)，非氯沙坦血管紧张素受体阻滞剂为1.29（1.16 - 1.43）。在没有高血压的人群中也得到了类似的结果。高血压患者使用钙通道阻滞剂持续时间的多因素相对危险度，小于1年的为1.02,1-1.9年的为0.88,2年及以上的为0.75，使用氯沙坦的多因素相对危险度分别为0.98,0.87和0.71（趋势P均<0.05）。结论：钙通道阻滞剂和氯沙坦具有降低尿酸的特性，与高血压患者发生痛风的风险较低相关。相比之下，利尿剂、β受体阻滞剂、血管紧张素转换酶抑制剂和非氯沙坦血管紧张素II受体阻滞剂与痛风风险增加相关。
Objective To determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Design Nested case-control study. Setting UK general practice database, 2000-7. Participants All incident cases of gout (n=24 768) among adults aged 20-79 and a random sample of 50 000 matched controls. Main outcome measure Relative risk of incident gout associated with use of antihypertensive drugs. Results After adjusting for age, sex, body mass index, visits to the general practitioner, alcohol intake, and pertinent drugs and comorbidities, the multivariate relative risks of incident gout associated with current use of antihypertensive drugs among those with hypertension (n=29 138) were 0.87 (95% confidence interval 0.82 to 0.93) for calcium channel blockers, 0.81 (0.70 to 0.94) for losartan, 2.36 (2.21 to 2.52) for diuretics, 1.48 (1.40 to 1.57) for β blockers, 1.24 (1.17 to 1.32) for angiotensin converting enzyme inhibitors, and 1.29 (1.16 to 1.43) for non-losartan angiotensin II receptor blockers. Similar results were obtained among those without hypertension. The multivariate relative risks for the duration of use of calcium channel blockers among those with hypertension were 1.02 for less than one year, 0.88 for 1-1.9 years, and 0.75 for two or more years and for use of losartan they were 0.98, 0.87, and 0.71, respectively (both P<0.05 for trend). Conclusions Compatible with their urate lowering properties, calcium channel blockers and losartan are associated with a lower risk of incident gout among people with hypertension. By contrast, diuretics, β blockers, angiotensin converting enzyme inhibitors, and non-losartan angiotensin II receptor blockers are associated with an increased risk of gout.
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影响因子：
64.8
作者：
Enomoto, A;Kimura, H;Endou, H
通讯作者：
Endou, H
影响因子：
6.1
作者：
Chanard, J;Toupance, O;Moulin, B
通讯作者：
Moulin, B
DOI：
10.3109/10641968709164241
发表时间：
1987-01-01
期刊：
CLINICAL AND EXPERIMENTAL HYPERTENSION PART A-THEORY AND PRACTICE
影响因子：
--
作者：
MALINI, PL;STROCCHI, E;AMBROSIONI, E
通讯作者：
AMBROSIONI, E
影响因子：
6.2
作者：
Minghelli, G;Seydoux, C;Burnier, M
通讯作者：
Burnier, M
影响因子：
1.2
作者：
Hamada, T;Hisatome, I;Yamamoto, T
通讯作者：
Yamamoto, T