1 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
2 Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Aust N Z J Psychiatry. 2018 Jan;52(1):24-38. doi: 10.1177/0004867417721654. Epub 2017 Jul 28.
It is unclear whether blockade of the angiotensin system has effects on mental health. Our objective was to determine the impact of angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor (AT1R) blockers on mental health domain of quality of life.
Meta-analysis of published literature.
PubMed and clinicaltrials.gov databases. The last search was conducted in January 2017.
Randomized controlled trials comparing any angiotensin converting enzyme inhibitor or AT1R blocker versus placebo or non-angiotensin converting enzyme inhibitor or non-AT1R blocker were selected. Study participants were adults without any major physical symptoms. We adhered to meta-analysis reporting methods as per PRISMA and the Cochrane Collaboration.
Eleven studies were included in the analysis. When compared with placebo or other antihypertensive medications, AT1R blockers and angiotensin converting enzyme inhibitors were associated with improved overall quality of life (standard mean difference = 0.11, 95% confidence interval = [0.08, 0.14], p < 0.0001), positive wellbeing (standard mean difference = 0.11, 95% confidence interval = [0.05, 0.17], p < 0.0001), mental (standard mean difference = 0.15, 95% confidence interval = [0.06, 0.25], p < 0.0001), and anxiety (standard mean difference = 0.08, 95% confidence interval = [0.01, 0.16], p < 0.0001) domains of QoL. No significant difference was found for the depression domain (standard mean difference = 0.05, 95% confidence interval = [0.02, 0.12], p = 0.15).
Use of angiotensin blockers and inhibitors for the treatment of hypertension in otherwise healthy adults is associated with improved mental health domains of quality of life. Mental health quality of life was a secondary outcome in the included studies. Research specifically designed to analyse the usefulness of drugs that block the angiotensin system is necessary to properly evaluate this novel psychiatric target.
目前尚不清楚血管紧张素系统阻断剂对心理健康是否有影响。本研究旨在确定血管紧张素转换酶抑制剂（ACEI）和血管紧张素Ⅱ型 1 型受体（AT1R）阻滞剂对生活质量心理领域的影响。
对已发表文献进行的荟萃分析。
PubMed 和 clinicaltrials.gov 数据库。最后一次检索时间为 2017 年 1 月。
入选了比较 ACEI 或 AT1R 阻滞剂与安慰剂或非 ACEI 或非 AT1R 阻滞剂的随机对照试验。研究对象为无明显躯体症状的成年人。我们严格遵循 PRISMA 和 Cochrane 协作组的荟萃分析报告方法。
11 项研究纳入分析。与安慰剂或其他降压药物相比，AT1R 阻滞剂和 ACEI 与整体生活质量的改善相关（标准均数差=0.11，95%置信区间[0.08，0.14]，p<0.0001），积极的幸福感（标准均数差=0.11，95%置信区间[0.05，0.17]，p<0.0001），心理（标准均数差=0.15，95%置信区间[0.06，0.25]，p<0.0001）和焦虑（标准均数差=0.08，95%置信区间[0.01，0.16]，p<0.0001）生活质量领域。抑郁领域无显著差异（标准均数差=0.05，95%置信区间[0.02，0.12]，p=0.15）。
在其他方面健康的成年人中，使用血管紧张素受体阻滞剂和抑制剂治疗高血压与改善心理健康生活质量领域相关。心理健康生活质量是纳入研究的次要结果。有必要进行专门设计以分析阻断血管紧张素系统药物的作用，以正确评估这一新型精神治疗靶点。
