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通过诊室和家庭血压测量评估血管紧张素受体阻滞剂。远程家庭血压监测研究。

Angiotensin Receptor Blockers Evaluated by Office and Home Blood Pressure Measurements. TeleHBPM Study.

作者信息

Barroso Weimar Kunz Sebba, Brandão Andréa Araujo, Vitorino Priscila Valverde de Oliveira, Feitosa Audes Diógenes de Magalhães, Barbosa Eduardo Costa Duarte, Miranda Roberto Dischinger, Redon Josep, Camafort-Babkowski Miguel, Coca Antonio, Gomes Marco Antônio Mota

机构信息

Universidade Federal de Goiás - Liga de Hipertensão Arterial, Goiânia, GO - Brasil.

Universidade do Estado do Rio de Janeiro - Cardiologia, Rio de Janeiro, RJ - Brasil.

出版信息

Arq Bras Cardiol. 2022 May 9;118(6):1069-82. doi: 10.36660/abc.20210504.

Abstract

BACKGROUND

Adequate treatment of arterial hypertension and achieving arterial hypertension goals in are important in reducing cardiovascular outcomes.

OBJECTIVES

To describe angiotensin receptor blockers in monotherapy or double combination therapy and the rate of arterial hypertension control.

METHODS

This cross-sectional study evaluated patients who were using angiotensin receptor blockers between 2017 and 2020. Those using three or more antihypertensive drugs were excluded. The analyzed variables included sex, age, body mass index, valid home blood pressure monitoring (HBPM) measurements, casual and HBPM systolic and diastolic blood pressure measurements, blood pressure variability, and antihypertensive and angiotensin receptor blocker class. Paired t, chi-square, and Fisher's exact tests were used, as well as overlapping 95% confidence intervals and a significance level of 5% (p < 0.05).

RESULTS

Of 17,013 patients, 12,813 met the inclusion criteria, 62.1% of whom were female. The mean number of valid measurements was 23.3 (SD, 2.0). The mean HBPM and casual measurements for systolic blood pressure were 126.8 (SD, 15.8) mmHg and 133.5 (SD, 20.1) mmHg (p <0.001), respectively, while those for diastolic blood pressure were 79.1 (SD, 9.7 mmHg) and 83.6 (SD, 11.9) mmHg (p <0.001), respectively. Losartan was the most common angiotensin receptor blocker and resulted in the highest blood pressure values. Combinations of angiotensin receptor blockers with diuretics or calcium channel antagonists resulted in lower blood pressure values.

CONCLUSIONS

More than half of the patients used losartan, although it was the least efficient drug for reducing and controlling blood pressure.

摘要

背景

充分治疗动脉高血压并实现动脉高血压目标对于降低心血管疾病结局至关重要。

目的

描述单药治疗或联合治疗中的血管紧张素受体阻滞剂以及动脉高血压控制率。

方法

这项横断面研究评估了2017年至2020年间使用血管紧张素受体阻滞剂的患者。排除使用三种或更多种抗高血压药物的患者。分析的变量包括性别、年龄、体重指数、有效的家庭血压监测(HBPM)测量值、随机及HBPM收缩压和舒张压测量值、血压变异性以及抗高血压药物和血管紧张素受体阻滞剂类别。使用了配对t检验、卡方检验和费舍尔精确检验,以及重叠的95%置信区间和5%的显著性水平(p<0.05)。

结果

在17013名患者中,12813名符合纳入标准,其中62.1%为女性。有效测量的平均次数为23.3次(标准差,2.0)。收缩压的平均HBPM测量值和随机测量值分别为126.8(标准差,15.8)mmHg和133.5(标准差,20.1)mmHg(p<0.001),而舒张压的平均测量值分别为79.1(标准差,9.7 mmHg)和83.6(标准差,11.9)mmHg(p<0.001)。氯沙坦是最常用的血管紧张素受体阻滞剂,且导致的血压值最高。血管紧张素受体阻滞剂与利尿剂或钙通道拮抗剂联合使用可降低血压值。

结论

超过一半的患者使用氯沙坦,尽管它是降低和控制血压效果最差的药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bc7/9345159/d8e93f6bc102/0066-782X-abc-118-06-1069-gf01.jpg

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