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埃塞俄比亚西北部费莱格希沃特综合专科医院高血压门诊患者降脂治疗与血压控制的关联

The association of lipid-lowering therapy and blood pressure control among outpatients with hypertension at the Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.

作者信息

Abebe Rahel Belete, Kebede Sewnet Adem, Birarra Mequanent Kassa

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Front Cardiovasc Med. 2023 Mar 1;10:1071338. doi: 10.3389/fcvm.2023.1071338. eCollection 2023.

Abstract

BACKGROUND

The lipid-lowering medications known as statins have been shown in controlled clinical trials to have pleiotropic properties, such as lowering blood pressure, in addition to lowering cholesterol levels. The purpose of this study was to see if there was a possible link between blood pressure control and statin therapy in outpatients with hypertension in a real clinical setting.

PATIENTS AND METHODS

A retrospective comparative cohort study of 404 patients with hypertension was carried out. A systematic random sampling technique was used. For data entry, Epi-Data version 4.6 was used, and SPSS version 25 was used for further analysis. For group comparisons, chi-square and independent -tests were computed. To determine the relationship between statin use and blood pressure control, a binary logistic regression model was employed. To declare statistical significance, a 95% confidence interval and a -value of <0.05 were used.

RESULTS

Half of the study participants who were using a prescribed statin were assigned to the statin group, whereas the remaining participants who do not take statins were assigned to the control group. After 3 months of statin treatment, BP control to <130/80 mmHg was significantly greater ( = 0.022) in the statin group (52.5%) than in the control group (41.0%). The use of statins raises the likelihood of having blood pressure under control by 1.58 times when compared to statin non-users. After controlling for possible confounders, statin therapy still increased the odds of having controlled BP by a factor of 5.98 [OR = 5.98; 95% CI: 2.77-12.92].

CONCLUSION

This study revealed that blood pressure control was higher among statin user hypertensive patients. Favorable effects of statin use were independently observed, even after correction for age, presence of dyslipidemia, and duration of antihypertensive therapy. Therefore, the importance of concomitantly added lipid-lowering drugs such as statins and their role in managing poor blood pressure control should be given due emphasis.

摘要

背景

在对照临床试验中已表明,被称为他汀类药物的降脂药物除了能降低胆固醇水平外,还具有多效性,如降低血压。本研究的目的是探讨在实际临床环境中,高血压门诊患者的血压控制与他汀类药物治疗之间是否存在可能的联系。

患者与方法

对404例高血压患者进行了一项回顾性比较队列研究。采用系统随机抽样技术。数据录入使用Epi-Data 4.6版本,进一步分析使用SPSS 25版本。进行组间比较时,计算卡方检验和独立样本t检验。为了确定他汀类药物使用与血压控制之间的关系,采用二元逻辑回归模型。以95%置信区间和P值<0.05表示具有统计学意义。

结果

使用处方他汀类药物的研究参与者中有一半被分配到他汀类药物组,而其余未服用他汀类药物的参与者被分配到对照组。他汀类药物治疗3个月后,他汀类药物组血压控制在<130/80 mmHg的比例(分别为52.5%)显著高于对照组(41.0%)(P = 0.022)。与未使用他汀类药物的患者相比,使用他汀类药物使血压得到控制的可能性提高了1.58倍。在控制了可能的混杂因素后,他汀类药物治疗仍使血压得到控制的几率增加了5.98倍[比值比(OR)= 5.98;95%置信区间:2.77 - 12.92]。

结论

本研究表明,使用他汀类药物的高血压患者血压控制情况更好。即使在校正年龄血脂异常情况和抗高血压治疗持续时间后,仍独立观察到使用他汀类药物的有益效果。因此,应适当强调同时添加他汀类药物等降脂药物的重要性及其在管理血压控制不佳方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d1e/10014929/4352f34bf35f/fcvm-10-1071338-g0001.jpg

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