Hypertension Research Centre, Division of Medicine and Therapeutics, Ninewells Hospital, Dundee DD1 9SY, UK.
Int J Clin Pract. 2010 May;64(6):746-55. doi: 10.1111/j.1742-1241.2010.02346.x.
To examine whether the blood pressure (BP) profiles of lumiracoxib and high-dose ibuprofen differed in patients treated with different classes of antihypertensive medications.
A 4-week, multicentre, randomised, double-blind study has compared the effects of lumiracoxib 100 mg once daily (od) (n = 394) and ibuprofen 600 mg three times daily (tid) (n = 393) on ambulatory BP in osteoarthritis (OA) patients with controlled hypertension. Here, we present subgroup analyses for patients receiving different antihypertensive classes. The primary outcome was a comparison of the change in 24-h mean systolic ambulatory BP (MSABP) from baseline to week 4. Patients receiving angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) represented the largest subgroups receiving antihypertensive monotherapy.
For patients receiving an ARB monotherapy, the least squares mean (LSM) 24-h MSABP at week 4 fell with lumiracoxib 100 mg od and increased with ibuprofen 600 mg tid, creating an estimated treatment difference of 8.1 mmHg in favour of lumiracoxib (p < 0.001). For patients receiving an ACEI and a beta-blocker monotherapy, the estimated treatment difference was 8.2 mmHg (p < 0.001) and 5.8 mmHg (p = 0.002) in favour of lumiracoxib respectively. These treatment differences were greater than observed in the overall population (5.0 mmHg in favour of lumiracoxib). In patients receiving diuretics or calcium channel blockers, treatment differences in MSABP were smaller and not statistically significant, although they remained in favour of lumiracoxib.
Lumiracoxib 100 mg od resulted in less destabilisation of BP than high-dose ibuprofen 600 mg tid, and this effect was the greatest in subgroups treated with drugs blocking the renin-angiotensin system.
研究在接受不同类别的降压药物治疗的患者中,昔布类药物(lumiracoxib)和高剂量布洛芬的血压(BP)谱是否存在差异。
一项为期 4 周、多中心、随机、双盲研究比较了昔布类药物(lumiracoxib)100mg 每日一次(od)(n=394)和布洛芬(ibuprofen)600mg 每日三次(tid)(n=393)在高血压控制良好的骨关节炎(OA)患者中的降压作用。这里,我们呈现了亚组分析结果,包括接受不同降压药物的患者。主要结局是比较从基线到第 4 周时 24 小时平均收缩压(MSABP)的变化。接受血管紧张素受体阻滞剂(ARBs)或血管紧张素转换酶抑制剂(ACEIs)的患者代表了接受降压单药治疗的最大亚组。
对于接受 ARB 单药治疗的患者,第 4 周时 24 小时 MSABP 的最小二乘均数(LSM)随着昔布类药物(lumiracoxib)100mg od 下降,而随着布洛芬(ibuprofen)600mg tid 上升,这表明昔布类药物(lumiracoxib)治疗有 8.1mmHg 的估计治疗差异(p<0.001)。对于接受 ACEI 和β受体阻滞剂单药治疗的患者,估计的治疗差异分别为 8.2mmHg(p<0.001)和 5.8mmHg(p=0.002),均有利于昔布类药物(lumiracoxib)。这些治疗差异大于总体人群(昔布类药物治疗有 5.0mmHg 的优势)。在接受利尿剂或钙通道阻滞剂的患者中,MSABP 的治疗差异较小且无统计学意义,但仍有利于昔布类药物(lumiracoxib)。
昔布类药物(lumiracoxib)100mg od 导致的血压不稳定程度低于高剂量布洛芬(ibuprofen)600mg tid,在接受抑制肾素-血管紧张素系统药物治疗的亚组中,这种作用最大。