A summary of the effects of anti hypertensive medications on measured blood pressure
A summary of the effects of anti hypertensive medications on measured blood pressure
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DOI：
10.1016/j.amjhyper.2005.01.011
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发表时间：
2005-07-01
影响因子：
3.2
通讯作者：
Rao, DC
中科院分区：
文献类型：
--
作者：
Wu, J;Kraja, AT;Rao, DC
背景：对血压（BP）家族资料的流行病学分析经常受到抗高血压药物作用的影响。大量的临床试验，调查降压药物的影响的审查总结here.Methods：发表的临床试验，包括137个临床试验与单药，治疗和28个临床试验的联合药物治疗，共11,739名参与者，从PubMed进行了审查。根据种族将抗高血压药物分为六大类/组，包括血管紧张素转换酶（ACE）抑制剂、α 1受体阻滞剂、心脏选择性β受体阻滞剂（β 1受体阻滞剂）、钙通道阻滞剂、噻嗪类利尿剂和髓袢利尿剂。使用坐位或仰卧位BP，对于合并的种族群体，ACE抑制剂单药治疗显示收缩压和舒张压降低的加权平均效应为42.5/9.5 mm Hg，α 1受体阻滞剂降低15.5/11.7 mm Hg，β（1）受体阻滞剂14.8/12.2 mm Hg;钙通道阻滞剂15.3/10.5 mm Hg;噻嗪类利尿剂15.3/9.8 mm Hg;髓袢利尿剂15.8/8.2 mm Hg。然而，ACE抑制剂、α 1受体阻滞剂和β 1受体阻滞剂在非裔美国人中的疗效低于非裔美国人，而钙通道阻滞剂、噻嗪类利尿剂和袢利尿剂在非裔美国人中的疗效高于非裔美国人。对于两种药物联合治疗的种族组合，第二种药物的降压效果，当与单药治疗相比，收缩压和舒张压分别为84%和65%。结论：本文报道的降血压作用可用于估算治疗前的血压水平，这可以提高信息含量，从而提高在使用降压药物是BP测量中的混杂因素的研究中流行病学分析的能力。
Background: Epidemologic analysis of family data on blood pressure (BP) is often compromised by the effects of antihypertensive medications. A review of numerous clinical trials that investigated the effects of BP-lowering medications is summarized here.Methods: Published clinical trials, including 137 clinical trials with monodrug, therapies and 28 clinical trials of combination drug therapies with a total of 11,739 participants, were reviewed from PubMed. Six major classes/groups of antihypertensive medications were categorized by ethnicity, including angiotensin-converting enzyme (ACE) inhibitors, alpha(1)-blockers, cardioselective beta-blockers (beta(1)-blockers), calcium channel blockers, thiazide and thiazide-like diuretics, and loop diuretics.Results: Using sitting or supine BP, for ethnic groups combined, monodrug therapy with ACE inhibitors showed a weighted average effect of lowering the systolic and diastolic BP by 42.5/9.5 mm Hg; alpha(1)-blockers by 15.5/11.7 mm Hg; beta(1)-blockers by 14.8/12.2 mm Hg; calcium channel blockers by 15.3/10.5 mm Hg; thiazide diuretics by 15.3/9.8 mm Hg; and loop diuretics by 15.8/8.2 mm Hg. However, ACE inhibitors, alpha(1)-blockers, and beta(1)-blockers were less effective in African Americans than in non-African Americans, whereas calcium channel blockers, thiazide diuretics, and loop diuretics were more effective in African Americans than in non-African Americans. For two-drug combination therapy with ethnic groups combined, the BP-lowering effect of the second medication, when compared to its effect as monodrug therapy, was 84% and 65% for systolic and diastolic BP, respectively.Conclusions: The BP-lowering effects reported here may be used to impute the pretreatment BP levels, which can improve the information content and hence the power of epidemiologic analysis in studies where use of antihypertensive medications is a confounding factor in the BP measurements.