Wang Biqing, Zhao Junnan, Zhan Qiuxiao, Wang Rongyanqi, Liu Birong, Zhou Yan, Xu Fengqin
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2021 May 20;8:663635. doi: 10.3389/fcvm.2021.663635. eCollection 2021.
Postprandial hypotension (PPH) is an independent predictive factor of all-cause mortality in older people. Drug management has not achieved a satisfactory effect yet. In recent years, many studies have found that acarbose may be effective in the treatment of PPH with glucose metabolism disorders. To assess the efficacy and safety of acarbose on PPH with glucose metabolism disorders. PubMed (MEDLINE), Cochrane, EMBASE, Web of Science, Clinical Trials, and relevant Chinese databases were searched from inception to October 1, 2020. Randomized controlled studies of acarbose in the treatment of PPH with glucose metabolism disorders were included. Review Manager 5.3 software was used for quality evaluation and meta-analysis. GRADEpro GDT software was used to GRADE the evidence for the research objectives. A total of 4 randomized controlled studies including 202 participants were identified after screening. The meta-analysis showed that acarbose significantly attenuated the decrease in postprandial systolic blood pressure [weighted mean difference (MD): -9.84, 95% CI: -13.34 to -6.33], diastolic blood pressure (MD: -6.86, 95% CI: -12.89 to -0.83), and mean arterial pressure (MD: -8.10, 95% CI: -12.40 to -3.49) compared with the control group. One study reported a case of adverse reactions that included mild abdominal distension in the acarbose group (4.8%, 1/21). No adverse reactions were reported in the other three studies. Acarbose may attenuate the decrease in postprandial blood pressure and avoid the occurrence of PPH in patients with PPH and abnormal glucose metabolism disorders. More clinical trials are needed to make a clear conclusion. PROSPERO CRD42020171335.
餐后低血压（PPH）是老年人全因死亡率的独立预测因素。药物治疗尚未取得令人满意的效果。近年来，许多研究发现阿卡波糖可能对治疗伴有糖代谢紊乱的PPH有效。为评估阿卡波糖治疗伴有糖代谢紊乱的PPH的疗效和安全性。检索了PubMed（MEDLINE）、Cochrane、EMBASE、Web of Science、Clinical Trials以及相关中文数据库，检索时间从建库至2020年10月1日。纳入阿卡波糖治疗伴有糖代谢紊乱的PPH的随机对照研究。使用Review Manager 5.3软件进行质量评估和荟萃分析。使用GRADEpro GDT软件对研究目标的证据进行分级。筛选后共纳入4项随机对照研究，包括202名参与者。荟萃分析表明，与对照组相比，阿卡波糖显著减轻了餐后收缩压的下降[加权平均差（MD）：-9.84，95%置信区间（CI）：-13.34至-6.33]、舒张压（MD：-6.86，95%CI：-12.89至-0.83）和平均动脉压（MD：-8.10，95%CI：-12.40至-3.49）。一项研究报告了1例不良反应，阿卡波糖组出现轻度腹胀（4.8%，1/21）。其他三项研究未报告不良反应。阿卡波糖可能减轻餐后血压下降，避免伴有PPH和糖代谢异常紊乱患者发生PPH。需要更多的临床试验才能得出明确结论。国际前瞻性系统评价注册库编号：CRD42020171335。
