识别肥胖相关性高血压患者对抗高血压药物的治疗反应。
Identifying treatment response to antihypertensives in patients with obesity-related hypertension.
作者信息
Schrover Ilse M, Dorresteijn Jannick A N, Smits Jodine E, Danser A H Jan, Visseren Frank L J, Spiering Wilko
机构信息
Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands.
Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
出版信息
Clin Hypertens. 2017 Oct 24;23:20. doi: 10.1186/s40885-017-0077-x. eCollection 2017.
BACKGROUND
In patients with obesity-related hypertension (ORH), reaction to antihypertensive medication is likely influenced by patientcharacteristics.
METHODS
Effects of aliskiren, moxonidine and hydrochlorothiazide on 24-h blood pressure (BP) were compared to placebo. Linear mixed effect models were used to analyze the effect of patient characteristics on BP levels and treatment response.
RESULTS
Systolic BP response to aliskiren was higher in patients with a BMI > 30.7 kg/m2 compared to patients with a BMI ≤ 30.7 kg/m2 (-21 mmHg versus -4 mmHg). In patients with a hsCRP > 1.8 mg/L the systolic BP response to aliskiren was higher than in patients with a low hsCRP (-15 mmHg versus -7 mmHg). Hydrochlorothiazide (HCTZ) treatment effect on systolic BP was -13 mmHg when heart rate > 71 beats/min compared to -3 mmHg when heart rate was ≤ 71 beats/min.
CONCLUSION
In patients with ORH, BP response to aliskiren is positively related to BMI and hsCRP. Systolic BP response to HCTZ is positively related to heart rate and negatively to renin levels.
TRIAL REGISTRATION
NCT01138423. Registered June 4th, 2010.
背景
在肥胖相关性高血压（ORH）患者中，降压药物的反应可能受患者特征影响。
方法
将阿利吉仑、莫索尼定和氢氯噻嗪对24小时血压（BP）的影响与安慰剂进行比较。采用线性混合效应模型分析患者特征对血压水平和治疗反应的影响。
结果
与BMI≤30.7kg/m²的患者相比，BMI>30.7kg/m²的患者对阿利吉仑的收缩压反应更高（-21mmHg对-4mmHg）。hsCRP>1.8mg/L的患者对阿利吉仑的收缩压反应高于hsCRP较低的患者（-15mmHg对-7mmHg）。当心率>71次/分钟时，氢氯噻嗪（HCTZ）对收缩压的治疗效果为-13mmHg，而当心率≤71次/分钟时为-3mmHg。
结论
在ORH患者中，对阿利吉仑的血压反应与BMI和hsCRP呈正相关。对HCTZ的收缩压反应与心率呈正相关，与肾素水平呈负相关。
试验注册
NCT01138423。于2010年6月4日注册。
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