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多重药物不耐受综合征与动脉高血压——系统评价与荟萃分析

Multiple Drug Intolerance Syndrome and Arterial Hypertension-Systematic Review and Meta-Analysis.

作者信息

Rusinek Jakub, Tyjas Kinga, Ziółek Wiktoria, Rajzer Marek, Stolarz-Skrzypek Katarzyna

机构信息

Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-538 Krakow, Poland.

1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Jakubowskiego St. 2, 30-688 Krakow, Poland.

出版信息

J Clin Med. 2025 Sep 3;14(17):6218. doi: 10.3390/jcm14176218.

Abstract

Arterial hypertension (HT) is one of the most prevalent diseases, causing increased morbidity and mortality. Treatment of HT might be complicated by multiple drug intolerance syndrome (MDIS), defined as intolerance to three or more drug classes. This systematic review and meta-analysis aimed to assess the prevalence of MDIS in patients with hypertension and investigate its impact on disease control. MEDLINE, Scopus, Web of Science, and Embase were thoroughly searched in June 2024. The data concerning MDIS prevalence, MDIS risk factors, number of adverse drug reactions (ADRs), and types of reactions was extracted. Quality assessment was done with the use of the Newcastle-Ottawa Scale. Meta-analysis was conducted to determine the pooled prevalence of MDIS and ADRs. The study was conducted according to the PRISMA guidelines. This review included four studies (2508 patients). The pooled prevalence of MDIS was 10% (95% CI: 4%-19%). Headache was the most frequent ADR reported in the studies (71.47%, 95% CI: 56.5%-84.44%), while pain in other body parts was present in 53.08% of patients. Female sex was found to increase the risk of MDIS in each included study. Other risk factors identified were older age, gastrointestinal disorders, anxiety disorders, panic attacks, and depression. Blood pressure was higher in the MDIS group, and in this group, more patients had uncontrolled hypertension. The prevalence of MDIS in the hypertensive population can be considered high. Furthermore, blood pressure control is worse in patients with MDIS. However, this phenomenon is still studied inadequately, and further research is necessary.

摘要

动脉高血压(HT)是最常见的疾病之一,会导致发病率和死亡率上升。HT的治疗可能会因多重药物不耐受综合征(MDIS)而变得复杂,MDIS被定义为对三种或更多药物类别不耐受。本系统评价和荟萃分析旨在评估高血压患者中MDIS的患病率,并调查其对疾病控制的影响。2024年6月对MEDLINE、Scopus、科学网和Embase进行了全面检索。提取了有关MDIS患病率、MDIS危险因素、药物不良反应(ADR)数量和反应类型的数据。使用纽卡斯尔-渥太华量表进行质量评估。进行荟萃分析以确定MDIS和ADR的合并患病率。该研究按照PRISMA指南进行。本评价纳入了四项研究(2508名患者)。MDIS的合并患病率为10%(95%CI:4%-19%)。头痛是这些研究中报告的最常见ADR(71.47%,95%CI:56.5%-84.44%),而53.08%的患者存在身体其他部位疼痛。在每项纳入研究中均发现女性会增加MDIS的风险。确定的其他危险因素包括年龄较大、胃肠道疾病、焦虑症、惊恐发作和抑郁症。MDIS组的血压较高,且该组中更多患者患有未控制的高血压。高血压人群中MDIS的患病率可被认为较高。此外,MDIS患者的血压控制较差。然而,这一现象仍研究不足,有必要进一步开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1470/12428949/798069664e68/jcm-14-06218-g001.jpg

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