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Neurology:血管紧张素 II 刺激型抗高血压药,或有助于预防痴呆

2021-01-01 MedSci原创 MedSci原创

血管紧张素 II 刺激型抗高血压药,或有助于预防痴呆

 
中年高血压与痴呆风险增加有关。然而,对老年人降低血压的研究表明,降低老年痴呆症的风险有多种效果。越来越多的证据表明,一些抗高血压药亚类可能会减少痴呆事件超过其对 BP 的影响。与其他抗高血压药物相比,与降低痴呆风险最相关的亚类是血管紧张素受体阻滞剂、某些钙通道阻滞剂和利尿剂。
 
根据“血管紧张素假说” ,评估血管紧张素 II 刺激型降压药(噻嗪类、二氢吡啶类钙通道阻滞剂和血管紧张素 I 受体阻滞剂)是否比血管紧张素 II 抑制型降压药(血管紧张肽I转化酶抑制剂、 β 受体阻滞剂和非二氢吡啶类钙通道阻滞剂)具有更低的痴呆发生风险。
 
阿姆斯特丹大学的Jan Willem van Dalen等人,采用 Cox 回归分析方法,对1909名70ー78岁无痴呆症的社区居民(54% 女性)进行6ー8年随访。探II类血管紧张素刺激型和抑制型降压药对痴呆风险的影响。
结果显示,平均随访6.7年后,血管紧张素 II 刺激型:痴呆发生率为5.6% (27/480) ;血管紧张素 II 抑制型:痴呆发生率为8.2% (59/721) ;同时联用:痴呆发生率为6.9% (46/669)。经血压和病史等痴呆危险因素调整后,与血管紧张素 II抑制性的抗压药使用者相比,血管紧张素 II 刺激性降压药使用者痴呆发生率降低45% ,联用时痴呆发生率降低20% 。
 
该研究的主要意义在于:和血管紧张素 II 抑制型降压药相比,血管紧张素 II 刺激型抗高血压药使用者的痴呆发生率较低,支持血管紧张素假说。如果这个研究能够被其他类似研究重复,对于接受抗高血压治疗的老年人来说,通过使用血管紧张素 II 刺激型抗高血压药,或许能有助于预防痴呆。
 
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    2021-09-01 yinhl1978
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    2021-01-01 junJUN

    老年人痴呆何药可用??

    0

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    2021-01-01 yangchou

    血压控制对降低痴呆发生风险的机制有待研究。

    0

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    2021-01-01 weigq

    好文!!

    0

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