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高血压患者的抗焦虑治疗。

Antianxiety treatment in patients with excessive hypertension.

作者信息

Grossman Ehud, Nadler Moshe, Sharabi Yehonatan, Thaler Michael, Shachar Amir, Shamiss Arie

机构信息

Internal Medicine D and the Hypertension Unit, The Chaim Sheba Medical Center, Tel Aviv University, Sackler School of Medicine, Tel-Hashomer 52621, Israel.

出版信息

Am J Hypertens. 2005 Sep;18(9 Pt 1):1174-7. doi: 10.1016/j.amjhyper.2005.03.728.

Abstract

OBJECTIVE

There are no guidelines on how to treat patients with excessive hypertension. Anxiety is a common cause of excessive hypertension and therefore antianxiety treatment may be beneficial in these patients. We therefore compared the efficacy and safety of antianxiety treatment with sublingual captopril administration in patients with excessive hypertension and no evidence of acute target organ damage.

METHODS

Thirty-six patients (28 women and 8 men), mean age 60 +/- 2 years (range 36 to 85 years) who were referred to the emergency room because of excessive hypertension (>190/100 mm Hg) without evidence of acute target organ damage were randomized to receive either oral diazepam, 5 mg (n = 17, study group) or sublingual captopril, 25 mg (n = 19, control group). Blood pressure (BP) and heart rate were recorded hourly for 3 h.

RESULTS

Both treatments decreased BP significantly (from 213 +/- 5/105 +/- 3 to 170 +/- 8/88 +/- 6 mm Hg in the study group, and from 208 +/- 5/107 +/- 3 to 181 +/- 8/95 +/- 3 mm Hg in the control group (P < .01 v initial BP). One patient in each group was hospitalized because of sustained excessive hypertension.

CONCLUSIONS

Antianxiety treatment is effective in lowering BP in patients with excessive hypertension. Thus, anxiolytic treatment may be considered in patients with excessive hypertension without acute target organ damage. Further large placebo controlled studies are required to prove the benefit of anxiolytic agents.

摘要

目的

目前尚无关于如何治疗高血压急症患者的指南。焦虑是高血压急症的常见病因,因此抗焦虑治疗可能对这些患者有益。我们比较了抗焦虑治疗与舌下含服卡托普利对高血压急症且无急性靶器官损害证据患者的疗效和安全性。

方法

36例患者(28例女性和8例男性),平均年龄60±2岁(范围36至85岁),因高血压急症(>190/100 mmHg)被送至急诊室且无急性靶器官损害证据,被随机分为两组,分别口服5 mg地西泮(n = 17,研究组)或舌下含服25 mg卡托普利(n = 19,对照组)。每小时记录血压(BP)和心率,共记录3小时。

结果

两种治疗均使血压显著下降(研究组血压从213±5/105±3 mmHg降至170±8/88±6 mmHg,对照组从208±5/107±3 mmHg降至181±8/95±3 mmHg,与初始血压相比,P <.01)。每组各有1例患者因持续性高血压急症住院。

结论

抗焦虑治疗对高血压急症患者降低血压有效。因此,对于无急性靶器官损害的高血压急症患者可考虑使用抗焦虑治疗。需要进一步开展大规模安慰剂对照研究以证实抗焦虑药物的益处。

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