Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
J Clin Hypertens (Greenwich). 2021 Nov;23(11):2009-2015. doi: 10.1111/jch.14362. Epub 2021 Oct 17.
Hypertension was one common comorbidity of knee osteoarthritis (KOA), but the effect of different types of antihypertensive drugs on pain and joint space width (JSW) was unclear and not compared. Four hundred ninety KOA patients using one of the beta-blockers, ACE inhibitors, angiotensin receptor blockers, Calcium channel blockers (CCBs), or thiazide diuretics were followed for four years. The blood pressure, cumulative knee replacement rate, Womac pain, and JSW were compared among groups. All data were from the Osteoarthritis Initiative project. The CCBs group has the highest systolic blood pressure, replacement rate, and pain score at most visit timepoints. At baseline, the CCBs group was with significantly higher pain score than the beta-blockers group (3.3 vs 1.3, p < .05), the angiotensin receptor blockers group (3.3 vs 1.4, p < .05), and the thiazide diuretics group (3.3 vs 1.6, p < .05) in male; the CCBs group was with significantly higher pain score than the beta-blockers group (3.8 vs 2.0, p < .01), and the angiotensin receptor blockers group (3.8 vs 2.2, p < .05) in female. The results of females at 36 months were similar to the baseline. Among the common antihypertensive drugs, CCBs were associated with high replacement rates, high pain scores, and less JSW in KOA patients.
高血压是膝关节骨关节炎(KOA)的常见合并症之一,但不同类型的降压药对疼痛和关节间隙宽度(JSW)的影响尚不清楚,也未进行比较。490 名 KOA 患者使用β受体阻滞剂、ACE 抑制剂、血管紧张素受体阻滞剂、钙通道阻滞剂(CCB)或噻嗪类利尿剂中的一种进行治疗,随访 4 年。比较各组的血压、累计膝关节置换率、Womac 疼痛评分和 JSW。所有数据均来自骨关节炎倡议项目。CCB 组在大多数随访时间点的收缩压、置换率和疼痛评分最高。在基线时,CCB 组的疼痛评分明显高于β受体阻滞剂组(3.3 比 1.3,p<.05)、血管紧张素受体阻滞剂组(3.3 比 1.4,p<.05)和噻嗪类利尿剂组(3.3 比 1.6,p<.05)在男性中;CCB 组的疼痛评分明显高于β受体阻滞剂组(3.8 比 2.0,p<.01)和血管紧张素受体阻滞剂组(3.8 比 2.2,p<.05)在女性中。女性在 36 个月的结果与基线相似。在常用的降压药物中,CCB 与 KOA 患者的高置换率、高疼痛评分和 JSW 减少相关。