Residual coronary risk in men aged 50-59 years treated for hypertension and hyperlipidaemia in the population:: the PRIME study
Residual coronary risk in men aged 50-59 years treated for hypertension and hyperlipidaemia in the population:: the PRIME study
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DOI：
10.1097/00004872-200402000-00028
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发表时间：
2004-02-01
影响因子：
4.9
通讯作者：
Ducimetière, P
中科院分区：
文献类型：
--
作者：
Blacher, J;Evans, A;Ducimetière, P
目的由于目前工业化国家服用抗高血压和降脂药物的受试者比例正在增加，在人群水平上评估接受治疗的个体的冠状动脉风险，同时考虑其风险因素的达到水平是很重要的设计和方法我们使用来自心肌梗死前瞻性研究（PRIME）的数据，其中包括来自法国（三个中心）和北方爱尔兰（一个中心）（每个中心2500名男性，年龄50-59岁，无冠心病，随访5年），分析心血管药物使用与随后的冠状动脉风险之间的关系。结果抗高血压药物使用与随后的冠状动脉风险显著正相关（相对危险度= 1.60; 95%可信区间，1.18-2.16）与总冠状动脉风险，但不使用降脂药物（相对危险度= 1.15; 95%可信区间，0.77-1.73），同时调整经典的危险因素水平（年龄，吸烟，总胆固醇，高密度脂蛋白胆固醇和收缩压）。亚组分析显示，这些结果适用于β受体阻滞剂和钙通道拮抗剂，但不适用于利尿剂和血管紧张素转换酶抑制剂，适用于心绞痛和硬冠状动脉事件风险，但仅适用于法国人群，而不适用于贝尔法斯特人群。虽然PRIME研究的目的不是为了测试不同的药物，以防止冠心病的能力，这项分析提出了一个假设，即抗高血压药物可能与一个相当大的残余冠状动脉风险在中年mes.Conclusion治疗与抗高血压药物，β-受体阻滞剂和钙通道拮抗剂，特别是与一个相当大的残余冠状动脉风险。因此，在个体心血管风险评估中考虑抗高血压治疗似乎很重要。(C)2004年利平科特威廉姆斯威尔金斯。
Objective Since the proportion of subjects taking antihypertensive and lipid-lowering drugs is currently increasing in industrialized countries, it is important to evaluate, at the population level, coronary risk of treated individuals, while taking into account the achieved level of their risk factors (i.e. their 'residual coronary risk').Design and methods We used the data from the Prospective Study of Myocardial Infarction (PRIME), which involved populations from France (three centres) and Northern Ireland (one centre) (in each centre, 2500 men, aged 50-59 years, free of coronary heart disease, with a 5-year follow-up), to analyse the relationships between cardiovascular drug use and subsequent coronary risk.Results Anti hypertensive drug use was significantly positively associated (relative risk = 1.60; 95% confidence interval, 1.18-2.16) with total coronary risk, but not lipid-lowering drug use (relative risk = 1.15; 95% confidence interval, 0.77-1.73), while adjusting on classical risk factor levels (age, smoking, total cholesterol, high-density lipoprotein-cholesterol and systolic blood pressure). Subgroup analysis showed that these results applied to beta-blockers and calcium channel antagonists, but not to diuretics and angiotensin-converting enzyme inhibitors, to both angina pectoris and hard coronary event risk, but in the French population only and not in Belfast. Although the PRIME study was not designed to test the ability of different drugs to prevent coronary heart disease, this analysis raises the hypothesis that antihypertensive drugs could be associated with a sizeable residual coronary risk in middle-aged men.Conclusion Treatment with antihypertensive agents, beta-blockers and calcium channel antagonists in particular, was associated with a sizeable residual coronary risk. It seems, therefore, important to consider antihypertensive treatment in the cardiovascular risk assessment of individuals. (C) 2004 Lippincott Williams Wilkins.