Valdes Ana M, Abhishek Abhishek, Muir Kenneth, Zhang Weiya, Maciewicz Rose A, Doherty Michael
University of Nottingham, Nottingham City Hospital, and Arthritis Research UK Pain Centre, Nottingham, UK.
University of Nottingham, Nottingham City Hospital, Nottingham, UK.
Arthritis Care Res (Hoboken). 2017 Jul;69(7):1076-1081. doi: 10.1002/acr.23091. Epub 2017 Jun 7.
Recent findings suggest that β-adrenergic blockers have antinociceptive properties. The aim of this study was to compare levels of large-joint pain between those taking adrenergic blockers and those taking other antihypertensive medications.
Data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study, a secondary-care cohort of osteoarthritis (OA) patients, were used. Joint pain was assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores in 873 individuals with symptomatic hip and/or knee OA and hypertension, who were taking ≥1 prescription antihypertensive medications. The association between adrenergic blocker prescription and at least moderate joint pain (WOMAC score <75) and use of prescription analgesics was examined using binary logistic regression. Analyses were adjusted for age, sex, body mass index, knee or hip OA, history of joint replacement (at other joints), anxiety, and depression.
The use of β-adrenergic blockers was associated with lower WOMAC pain scores and with a lower prevalence of joint pain after adjustment for demographic variables and comorbidity (adjusted odds ratio [OR ] for pain 0.68 [95% confidence interval (95% CI) 0.51, 0.92]; P < 0.011). No associations with pain were observed with use of alpha-blockers (OR for pain 0.94 [95% CI 0.55, 1.58]) or with any other class of antihypertensive medications. Prescription of beta-blockers was also associated negatively with opioid use (OR for opioids 0.73 [95% CI 0.54, 0.98]; P < 0.037) and with the use of prescription analgesics in general (OR for analgesics 0.74 [95% CI 0.56, 0.94]; P < 0.032).
The use of beta-blockers is associated with less joint pain and a lower use of opioids and other analgesics in individuals with symptomatic large-joint OA. This observation needs to be confirmed by other studies.
近期研究结果表明，β-肾上腺素能阻滞剂具有抗伤害感受特性。本研究旨在比较服用肾上腺素能阻滞剂者与服用其他抗高血压药物者的大关节疼痛程度。
使用骨关节炎与生活方式遗传学（GOAL）研究的数据，该研究为骨关节炎（OA）患者的二级保健队列。对873例有症状的髋部和/或膝部OA及高血压患者使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）疼痛评分评估关节疼痛，这些患者正在服用≥1种处方抗高血压药物。使用二元逻辑回归分析肾上腺素能阻滞剂处方与至少中度关节疼痛（WOMAC评分<75）及处方镇痛药使用之间的关联。分析针对年龄、性别、体重指数、膝部或髋部OA、关节置换史（其他关节）、焦虑和抑郁进行了校正。
在对人口统计学变量和合并症进行校正后，使用β-肾上腺素能阻滞剂与较低的WOMAC疼痛评分以及较低的关节疼痛患病率相关（疼痛的校正比值比[OR]为0.68[95%置信区间（95%CI）0.51，0.92]；P<0.011）。使用α-阻滞剂（疼痛的OR为0.94[95%CI 0.55，1.58]）或任何其他类别的抗高血压药物均未观察到与疼痛的关联。β-阻滞剂的处方也与阿片类药物使用呈负相关（阿片类药物的OR为0.73[95%CI 0.54，0.98]；P<0.037）以及与一般处方镇痛药的使用呈负相关（镇痛药的OR为0.74[95%CI 0.56，0.94]；P<0.032）。
在有症状的大关节OA患者中，使用β-阻滞剂与较少的关节疼痛以及较低的阿片类药物和其他镇痛药使用相关。这一观察结果需要其他研究予以证实。
