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戒烟药物对心血管疾病患者或高风险评分患者血压和心率的影响:实际生活情况

Influence of smoking cessation drugs on blood pressure and heart rate in patients with cardiovascular disease or high risk score: real life setting.

作者信息

Silva André Pacheco, Scholz Jaqueline, Abe Tania Ogawa, Pinheiro Gabriela Gouveia, Gaya Patricia Viviane, Pereira Alexandre Costa, Santos Paulo Caleb Junior Lima

机构信息

Heart Institute University of Sao Paulo Medical School, Sao Paulo, Brazil.

Smoking Cessation Program Department, Heart Institute (InCor), University of Sao Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar 44, Cerqueira Cesar, 05403-900, Sao Paulo, SP, Brazil.

出版信息

BMC Cardiovasc Disord. 2016 Jan 5;16:2. doi: 10.1186/s12872-015-0180-4.

Abstract

BACKGROUND

Smoking is the most important reversible cardiovascular risk factor. It is well established that quitting smoking reduces coronary events. However, on several occasions, the cardiovascular safety of smoking cessation drugs has been questioned. Our goal is to evaluate the effects of smoking cessation drugs on blood pressure and heart rate in patients from a smoking cessation service in a cardiology hospital.

METHODS

We examined the PAF database (Smoking Cessation Assistance Program database) between January 2008 and March 2014. We analyzed data from 900 patients who were compliant with the treatment (50.5% male, average age 53 ± 17 years). The most frequent clinical diagnoses were coronary artery disease (25.2%), hypertension (57.2%), and diabetes (13.4%). Blood pressure, heart rate, and carbon monoxide (CO) concentration in exhaled air were analyzed at consecutive visits during the first 45 days of treatment (mean visits - 3). Analysis of repeated measures was used for the statistical analysis (p < 0.05).

RESULTS

Two hundred seventy one patients used nicotine replacement therapy (NRT) alone, 81 used bupropion alone, 154 used varenicline alone, 283 used NRT plus bupropion and 111 used bupropion plus varenicline. For all smoking cessation drugs, used alone or in combination, no increase occurred in the average value of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR). Significant reductions in CO concentrations occurred in all smoking cessation drug groups.

CONCLUSION

Smoking cessation drugs used in monotherapy or in combined regimens did not influence systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in this group of patients during the observation period.

摘要

背景

吸烟是最重要的可逆转心血管危险因素。众所周知,戒烟可减少冠心病事件。然而,戒烟药物的心血管安全性曾多次受到质疑。我们的目标是评估戒烟药物对一家心脏病医院戒烟服务患者血压和心率的影响。

方法

我们检查了2008年1月至2014年3月期间的PAF数据库(戒烟援助项目数据库)。我们分析了900例依从治疗患者的数据(男性占50.5%,平均年龄53±17岁)。最常见的临床诊断为冠状动脉疾病(25.2%)、高血压(57.2%)和糖尿病(13.4%)。在治疗的前45天内连续就诊时分析血压、心率和呼出气体中的一氧化碳(CO)浓度(平均就诊次数 - 3次)。采用重复测量分析进行统计分析(p < 0.05)。

结果

271例患者单独使用尼古丁替代疗法(NRT),81例单独使用安非他酮,154例单独使用伐尼克兰,283例使用NRT加安非他酮,111例使用安非他酮加伐尼克兰。对于所有单独或联合使用的戒烟药物,收缩压(SBP)、舒张压(DBP)和心率(HR)的平均值均未升高。所有戒烟药物组的CO浓度均显著降低。

结论

在该组患者的观察期内,单药治疗或联合治疗方案中使用的戒烟药物对收缩压(SBP)、舒张压(DBP)和心率(HR)均无影响。

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Cardiovascular effects of pharmacologic therapies for smoking cessation.戒烟药物治疗的心血管效应。
J Am Soc Hypertens. 2013 Jan-Feb;7(1):61-7. doi: 10.1016/j.jash.2012.11.003. Epub 2012 Dec 21.

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