标准化番茄提取物替代乙酰水杨酸用于原发性高血压和高心血管风险患者的随机对照试验

Standardised tomato extract as an alternative to acetylsalicylic acid in patients with primary hypertension and high cardiovascular risk - a randomised, controlled trial.

作者信息

Krasinska Beata, Osińska Angelika, Osinski Maciej, Krasinska Aleksandra, Rzymski Piotr, Tykarski Andrzej, Krasiński Zbigniew

机构信息

Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.

Department of Obstetrics, Gynaecology and Gynaecological Oncology, Division of Reproduction, Poznan University of Medical Sciences, Poznan Poland.

出版信息

Arch Med Sci. 2018 Jun;14(4):773-780. doi: 10.5114/aoms.2017.69864. Epub 2017 Sep 5.

INTRODUCTION

Cardiovascular (CV) diseases remain a leading global cause of death. It has been proven that the use of acetylsalicylic acid (ASA) in secondary prevention reduces the CV risk, while the benefits of ASA in primary prevention have recently been debated. The aim of the study was to compare the antiplatelet effect of standardised tomato extract (STE) and ASA in hypertensive patients with high CV risk.

MATERIAL AND METHODS

The study involved high-risk patients with arterial hypertension (AH) randomly assigned to one of two groups: group 1 included 33 patients receiving ASA and group 2 included 32 patients receiving STE. The platelet aggregation was determined using the VerifyNow analyser.

RESULTS

After 4 weeks of ASA treatment in group 1, a statistically significant reduction in aspirin reaction units (ARU) was observed ( < 0.001). However, the obese subgroup using ASA ( = 18) did not reveal a significant decrease in ARU ( > 0.05). After 4 weeks of STE treatment in the obese subgroup ( = 14), significant declines in ARU by 8.6% (95% CI: -19.5 to -1.7%; < 0.05) and in P2Y12 reaction units (PRU) by 7.5% (95% CI: -17.6 to 1.8%; < 0.05) were observed.

CONCLUSIONS

The antiplatelet effect of STE in hypertensive patients may be weight dependent. The group with AH and obesity might have potentially benefitted from STE treatment.

引言

心血管疾病仍然是全球主要的死亡原因。已证实，在二级预防中使用乙酰水杨酸（ASA）可降低心血管风险，而ASA在一级预防中的益处最近受到了质疑。本研究的目的是比较标准化番茄提取物（STE）和ASA对心血管风险较高的高血压患者的抗血小板作用。

材料与方法

该研究纳入了动脉高血压（AH）高危患者，随机分为两组：第1组包括33例接受ASA治疗的患者，第2组包括32例接受STE治疗的患者。使用VerifyNow分析仪测定血小板聚集情况。

结果

第1组患者接受ASA治疗4周后，阿司匹林反应单位（ARU）出现统计学显著降低（<0.001）。然而，使用ASA的肥胖亚组（=18）的ARU未出现显著下降（>0.05）。肥胖亚组（=14）接受STE治疗4周后，ARU显著下降8.6%（95%CI：-19.5至-1.7%；<0.05），P2Y12反应单位（PRU）显著下降7.5%（95%CI：-17.6至1.8%；<0.05）。