Chiba University Graduate School of Medicine, Chiba, Japan
Saga University, Saga, Japan.
RMD Open. 2022 Sep;8(2). doi: 10.1136/rmdopen-2022-002505.
Although uric acid lowering therapies, including xanthine oxidase (XO) inhibition, may reduce the absolute level of blood pressure (BP), the effect of XO inhibition on BP variability is largely unknown. The aim of the present analysis was to evaluate the impact of febuxostat, an XO inhibitor, on BP variability in a randomised trial setting.
This was a subanalysis of the PRIZE Study, a randomised trial to evaluate the potential effect of febuxostat on carotid intima-media thickness progression. Patients with hyperuricemia and carotid plaques were randomly assigned to the febuxostat or control group. During a 24-month period, office BP and pulse rate (PR) were measured ≥3 times. BP and PR variabilities were assessed with SD and coefficient of variation (CV). The effect of febuxostat on BP and PR variabilities was adjusted with age, sex and baseline BP or PR, expressed with 95% CIs.
A total of 472 patients were included into the present subanalysis. During the 24-month follow-up period, the febuxostat group had a significantly lower adjusted mean systolic BP (128.4 (126.8-130.0) vs 130.7 (129.1-132.2) mm Hg, p=0.04) and CV of systolic BP (7.4 (6.7-8.0) vs 8.2 (7.6-8.8), p=0.04) than the control group. Adjusted SD of PR was also lower in the febuxostat group than their counterpart (5.95 (4.93-6.97) vs 7.33 (6.32-8.33), p=0.04).
XO inhibition with febuxostat was associated with reduced visit-to-visit BP variability as well as reduced PR variability in patients with hyperuricemia and carotid plaques.
University Hospital Medical Information Network Clinical Trial Registry (UMIN000012911 and UMIN000041322).
尽管尿酸降低疗法，包括黄嘌呤氧化酶（XO）抑制剂，可能会降低血压（BP）的绝对水平，但 XO 抑制对 BP 变异性的影响在很大程度上尚不清楚。本分析的目的是评估黄嘌呤氧化酶抑制剂非布司他对随机试验设定中 BP 变异性的影响。
这是 PRIZE 研究的亚分析，该研究是一项随机试验，旨在评估非布司他对颈动脉内膜中层厚度进展的潜在影响。患有高尿酸血症和颈动脉斑块的患者被随机分配到非布司他组或对照组。在 24 个月期间，≥3 次测量诊室 BP 和脉搏率（PR）。使用标准差（SD）和变异系数（CV）评估 BP 和 PR 变异性。用年龄、性别和基线 BP 或 PR 调整非布司他对 BP 和 PR 变异性的影响，用 95%置信区间（CI）表示。
共有 472 例患者纳入本亚分析。在 24 个月的随访期间，非布司他组的调整平均收缩压（128.4（126.8-130.0）与 130.7（129.1-132.2）mmHg，p=0.04）和收缩压 CV（7.4（6.7-8.0）与 8.2（7.6-8.8），p=0.04）明显低于对照组。非布司他组的 PR 标准差也低于对照组（5.95（4.93-6.97）与 7.33（6.32-8.33），p=0.04）。
黄嘌呤氧化酶抑制剂非布司他可降低高尿酸血症和颈动脉斑块患者的 BP 变异性和 PR 变异性。
日本大学医院医疗信息网络临床试验注册（UMIN000012911 和 UMIN000041322）。
