Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Hypertension Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Hypertens. 2018 Mar 10;31(4):431-437. doi: 10.1093/ajh/hpx188.
The effect of chronic benzodiazepine use on blood pressure has not been documented. We aimed to evaluate whether regular benzodiazepine use can be associated to the results of ambulatory blood pressure monitoring (ABPM).
A retrospective analysis of the ABPM database between 2009 and 2015 was performed. The study groups were divided according to benzodiazepine treatment at least 3 months before ABPM. Generalized estimating equation (GEE) model analysis was conducted to estimate the association between benzodiazepine treatment and ABPM test measurements. Multivariable COX regression survival analysis model for mortality and cardiovascular (CV) events was performed.
A total of 4,938 ABPM studies were included in final analysis, 670 ABPMs of benzodiazepine-treated patients, and 4,268 of untreated patients. The benzodiazepine-treated group was significantly older, with a predominance of female patients, comprised more diabetic patients and consumed more antihypertensive medications. Adjustment for age, gender, diabetes mellitus, and number of antihypertensive medications, showed an association between benzodiazepine treatment and significantly lower ABPM measurements. When the analysis was split into those ≥60 years old and the other <60 years old, regular benzodiazepine consumption was associated with lower ABPM measurements only among ≥60 years old. Multivariable Cox regression survival analysis showed that regular benzodiazepine consumption was not associated with increased mortality or CV events (mean follow-up period of 42.4 ± 19.8 and 42.1 ± 20.0 months, respectively).
Long-term use of benzodiazepines by ≥60 years old was independently associated with lower diastolic and systolic blood pressure in all parameters of ABPM, but not among younger patients.
慢性苯二氮䓬类药物使用对血压的影响尚未被记录。我们旨在评估常规苯二氮䓬类药物的使用是否与动态血压监测（ABPM）的结果有关。
对 2009 年至 2015 年之间的 ABPM 数据库进行了回顾性分析。根据 ABPM 前至少 3 个月的苯二氮䓬类药物治疗情况将研究组进行分组。使用广义估计方程（GEE）模型分析来评估苯二氮䓬类药物治疗与 ABPM 测试测量之间的关联。进行多变量 COX 回归生存分析模型以评估死亡率和心血管（CV）事件。
共有 4938 项 ABPM 研究被纳入最终分析，其中 670 项 ABPM 来自苯二氮䓬类药物治疗的患者，4268 项来自未治疗的患者。与未治疗组相比，苯二氮䓬类药物治疗组的患者年龄更大，女性患者居多，患有更多的糖尿病患者，并服用了更多的降压药物。在调整年龄、性别、糖尿病和降压药物数量后，发现苯二氮䓬类药物治疗与 ABPM 测量值明显降低之间存在关联。当将分析分为年龄≥60 岁和<60 岁时，只有年龄≥60 岁的患者中，常规苯二氮䓬类药物的使用与 ABPM 测量值较低相关。多变量 Cox 回归生存分析显示，常规苯二氮䓬类药物的使用与死亡率或 CV 事件的增加无关（平均随访时间分别为 42.4±19.8 个月和 42.1±20.0 个月）。
年龄≥60 岁的患者长期使用苯二氮䓬类药物与 ABPM 的所有参数中的舒张压和收缩压均独立相关，但在年轻患者中则没有相关性。
