THE RELATIVE RISK OF INCIDENT CORONARY HEART-DISEASE ASSOCIATED WITH RECENTLY STOPPING THE USE OF BETA-BLOCKERS
THE RELATIVE RISK OF INCIDENT CORONARY HEART-DISEASE ASSOCIATED WITH RECENTLY STOPPING THE USE OF BETA-BLOCKERS
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DOI：
10.1001/jama.263.12.1653
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发表时间：
1990-03-23
影响因子：
120.7
通讯作者：
INUI, TS
中科院分区：
文献类型：
--
作者：
PSATY, BM;KOEPSELL, TD;INUI, TS
我们对高血压患者首次发生冠心病的危险因素进行了一项基于人群的病例对照研究。所有受试者均有高血压，并接受药物治疗。248例1982 ~ 1984年新发冠心病，737例为健康维护组织无冠心病患者的概率样本。健康维护组织的计算机化药房数据库确定了最近的“止药者”——那些没有按时按处方服药的患者，至少有80%的患者没有遵医嘱。在对潜在的混杂因素进行调整后，最近停止使用。-受体阻滞剂可使冠心病的相对危险度短暂增加4倍（相对危险度为4.5；95%可信区间为1.1 - 18.5）。这种关联是针对。beta的。-阻滞剂，但不是利尿剂。停药后立即出现的戒断综合症。在没有冠心病病史的高血压患者中，使用受体阻滞剂可能是心绞痛和心肌梗死的急性诱因。
We conducted a population-based, case-control study of risk factors for first events of coronary heart disease in patients with high blood pressure. All subjects had hypertension treated with medication. The 248 cases presented with new coronary heart disease from 1982 through 1984, and the 737 controls were a probability sample of health maintenance organization patients free of coronary heart disease. The health maintenance organizations computerized pharmacy database identified recent stoppers - patients who did not fill their prescriptions regularly enough to be at least 80% compliant. After adjustment for potential confounding factors, subjects who had recently stopped using .beta.-blockers had a transient fourfold increase in the relative risk of coronary heart disease (relative risk, 4.5; 95% confidence interval, 1.1 to 18.5). The association was specific to .beta.-blockers but not diuretics. A withdrawal syndrome immediately following the cessation of .beta.-blocker use may be an acute precipitant of angina and myocardial infarction in hypertensive patients who have no prior history of coronary heart disease.