A novel measurement index for antihypertensive medication burden and its use.
A novel measurement index for antihypertensive medication burden and its use.
复制标题
一种新的抗高血压药物负担测量指标及其应用。
DOI：
10.1161/hypertensionaha.109.140681
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Hajjar,Ihab
中科院分区：
文献类型：
--
作者：
Wan,Siu-Hin;Hart,Meaghan;Hajjar,Ihab
随着降压药的广泛使用，如果没有抗高血压药物的混杂作用，评估血压升高对生理和病理现象的影响变得极其困难。在观察性研究和随机临床试验中，试图解释降压效果的方法从过于简化的二分法（接受或不接受治疗）到繁琐的公式，在大多数情况下，这些公式无法在研究人群中计算出来。在这里，我们提出了一种新颖而简单的测量指标，它不仅考虑了个体是否正在接受治疗，而且考虑了所服用的每种抗高血压药物的数量和剂量。我们建议，这种方法可能优于二分法，可用于前瞻性地评估血压治疗的变化。在一项正在进行的试验“抗高血压和血管、内皮和认知功能”中，使用了开发的测量方法来评估干预前后抗高血压治疗的负担。抗高血压、血管、内皮和认知功能试验是一项双盲、随机临床试验，研究抗高血压药物对轻度认知障碍老年人的认知效果。作为研究方案的一部分，参与者逐渐停用常用的抗高血压药物，并开始使用其中一种研究药物（赖诺普利、坎地沙坦或氢氯噻嗪；第二步：硝苯地平XL；第三步：美托洛尔）。这种新的抗高血压负荷测量方法用于监测试验不同阶段参与者的药物负担。我们将降压负荷定义为当前每日剂量除以每种药物的最大推荐每日剂量之比的总和。从药物数据库中获得用于治疗高血压的每种药物的最大日剂量。已经为其他药物类别制定了类似但更复杂的药物负担指数。1
With the widespread use of blood pressure medications, it has become extremely difficult to assess the effects of elevated blood pressure on physiological and pathological phenomena without the confounding effects of antihypertensives. In both observational studies and randomized clinical trials, attempts to account for the antihypertensive effects have ranged from overly simplified dichotomous measures (either on or not on treatment) to tedious formulas that, in most instances, cannot be calculated in the population studied. Here, we propose a novel yet simple measurement index that not only takes into consideration whether an individual is on treatment but also accounts for the number and doses of each antihypertensive medication taken. We are suggesting that this measure maybe superior to the dichotomous measure and can be used to prospectively assess changes in blood pressure treatment. The developed measure was used in an ongoing trial, the Antihypertensive and Vascular, Endothelial, and Cognitive Function, to evaluate the burden of antihypertensive treatment before and after the intervention. The Antihypertensive and Vascular, Endothelial, and Cognitive Function Trial is a double-blind, randomized clinical trial examining the cognitive effects of antihypertensive medications among older adults with mild cognitive impairment. As part of the research protocol, participants were tapered off their usual antihypertensive medications and started on one of the study medications (lisinopril, candesartan, or hydrochlorothiazide; step 2: nifedipine XL; and step 3: metoprolol). This new measure of the antihypertensive load was used to monitor the drug burden of the participants during different phases of the trial. We define the antihypertensive load as the sum of the ratio of the current daily dosage divided by the maximum recommended daily dosage for each medication. The maximum daily dosage of each agent as indicated for hypertension was obtained from the drug database. A similar but more complex drug burden index has been developed for other drug classes. 1
噻吗洛尔和氢氯噻嗪，或氢氯噻嗪和阿米洛利对原发性高血压的长期影响
影响因子：
2.9
作者：
H. Castenfors
通讯作者：
H. Castenfors
原发性高血压赖诺普利的剂量-反应关系。
影响因子：
3.4
作者：
H. Gomez;V. Cirillo;J. A. Sromovsky;E. S. Otterbein;W. Shaw;J. Rush;S. Chrysant;A. Gradman;A. Leon;E. Maccarthy
通讯作者：
E. Maccarthy