Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: Observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials
Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: Observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials
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DOI：
10.1016/j.ahj.2005.08.004
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发表时间：
2005-12-01
影响因子：
4.8
通讯作者：
Newby, LK
中科院分区：
文献类型：
--
作者：
Frazier, CG;Shah, SH;Newby, LK
背景高血压影响着全球10亿人，是急性冠状动脉综合征（ACS）后死亡的独立危险因素。我们研究了SYMPHONY和2nd SYMPHONY试验中随机分配的15904例ACS患者中高血压的患病率和药物治疗。在美国和国际实践中，根据性别进行了总体分析。多变量模型确定了与使用抗高血压药物类的因素，并研究了高血压和性别的关联，与mortality.Results在美国，高血压是更普遍的女性比男性，整体（63%比50%），在每一个十分位数的年龄。高血压妇女更常接受钙通道阻滞剂（35%对30%）和利尿剂（33%对19%），而较少接受β受体阻滞剂（51%对57%）。血管紧张素转换酶抑制剂的使用相似（35% vs 34%）。女性接受多种药物的频率高于男性：2种药物，35%比30%; ≥ 3种药物，16%比13%。女性仅能独立预测利尿剂的药物类别使用。女性高血压患者的死亡率高于男性高血压患者;多变量校正后，死亡率相似，没有证据表明高血压与死亡率之间存在性别差异。虽然有国际上的变化，在使用个别类别的代理人，按性别的整体调查结果是相似的跨regions.Conclusion高血压是更普遍的女性比男性ACS，其医疗管理不同的性别，但其与死亡率是相似的。存在改善高血压妇女药物治疗和结局的机会。
Background Hypertension affects 1 billion individuals worldwide and is an independent risk factor for death after acute coronary syndromes (ACS).Methods We examined the prevalence and medical treatment of hypertension among 15904 ACS patients randomized in the SYMPHONY and 2nd SYMPHONY trials. Analyses were performed overall and according to sex for the United States and across international practice. Multivariable models identified factors associated with use of antihypertensive medication classes and examined the association of hypertension and sex, with mortality.Results In the United States, hypertension was more prevalent in women than in men, overall (63% vs 50%) and within every decile of age. Hypertensive women more often received calcium-channel blockers (35% vs 30%) and odiuretics (33% vs 19%) and less often received beta-blockers (51% vs 57%). Angiotensin-converting enzyme inhibitor use was similar (35% vs 34%). Women received multiple agents more frequently than did men: 2 agents, 35% vs 30%; >= 3 agents, 16% vs 13%. Female sex independently predicted drug-class use only for diuretics. Mortality was higher in hypertensive women than in hypertensive men; after multivariable adjustment, mortality was similar without evidence of a differential association between hypertension and mortality according to sex. Although there was international variation in the use of individual classes of agents, the overall findings by sex were similar across regions.Conclusion Hypertension is more prevalent in women than in men with ACS, and its medical management varies by sex, but its association with mortality is similar. Opportunities exist to improve medical therapy and outcomes in women with hypertension.