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Int J Cardiol:房颤患者抗高血压药物及相关心血管药物与痴呆风险

2018-07-23 xing.T MedSci原创

由此可见,处方中含有抗高血压药物,包括噻嗪类/RAAS阻滞剂联合治疗和华法林的使用,与痴呆发病率降低有关。

老年人中房颤和痴呆症发病率很高;并且房颤患者患痴呆症的风险增加。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员旨在探究服用抗高血压药物和心血管药物治疗是否与较低的痴呆相关风险相关。

该研究纳入的所有患者年龄均超过45岁,并在初级保健中心被诊断为房颤;瑞典有12096名参与者(6580名男性和5516名女性)。研究人员排除了房颤发作前被诊断为痴呆的患者。研究人员使用Cox回归进行分析(风险比:HR和95%置信区间:CI),并调整了性别、年龄、社会经济因素和合并症等因素。

该研究共有750例患者(6.2%)发生间歇性痴呆,平均随访5.6年(共69214人次每年)。处方中含有噻嗪类药物HR为0.81(95%CI为0.66-0.99)和华法林HR为0.78(95%CI为0.66-0.92)的参与者患痴呆的风险低于处方中没有这些药物的参与者。使用1-4种不同的抗高血压药物(噻嗪类、β受体阻滞剂、血管活性钙通道阻滞剂或肾素血管紧张素醛固酮(RAAS)阻滞剂)与减少痴呆症有关;处方中没有抗高血压药物的参与者比较,处方中含有一至两种药物的参与者HR为0.80(95%CI为0.64-1.00),三种或四种药物的HR为0.63(95%CI为0.46-0.84)。 与没有的特定的组合相比,RAAS阻滞剂和噻嗪类组合最为显著HR为0.70(95%CI为0.53-0.92),而单独服用RAAS-阻断剂或噻嗪类都不显著。

由此可见,处方中含有抗高血压药物,包括噻嗪类/RAAS阻滞剂联合治疗和华法林的使用,与痴呆发病率降低有关。

原始出处:

PerWändell,et al. Antihypertensive drugs and relevant cardiovascular pharmacotherapies and the risk of incident dementia in patients with atrial fibrillation.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.07.106

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    2018-07-23 junJUN

    老年人痴呆何药可用??

    0

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