使用阻抗心动图指导降压药物选择:随机对照试验的系统回顾。

IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Anthony J Viera, Lauren Hart, Pedro Gomez Altamirano, Brandi Tuttle, Ashley Price, Andrew Sherwood
{"title":"使用阻抗心动图指导降压药物选择:随机对照试验的系统回顾。","authors":"Anthony J Viera, Lauren Hart, Pedro Gomez Altamirano, Brandi Tuttle, Ashley Price, Andrew Sherwood","doi":"10.1093/ajh/hpae090","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may allow better alignment of medication with the mechanism(s) underlying an individual's hypertension. We conducted a systematic review of randomized controlled trials of ICG compared to usual care for attainment of BP control.</p><p><strong>Methods: </strong>We searched Medline inclusive of the year 1946 to January 31, 2024, using a combination of MeSH terms and keywords. English-language articles were eligible for inclusion if they described results of a randomized controlled trial designed to compare ICG-guided BP-medication selection to usual care (i.e., clinician judgment/guidelines-based alone) among a sample of hypertensive patients.</p><p><strong>Results: </strong>Of 1,952 titles screened, 6 trials met inclusion criteria. The first was published in 2002 from a specialty clinic in the United States, and the most recent in 2021 from a specialty clinic in China. One trial was conducted in a primary care setting. Sample sizes ranged from 102 to 164. Participants randomized to ICG-guided antihypertensive medication had reduced BP in the short-term to a greater extent than those randomized to usual care, with odds ratios for BP control (<140/90 mm Hg) at 3 months ranging from 1.87 to 2.92. This effect was seen in both specialty clinics and in a primary care setting.</p><p><strong>Conclusions: </strong>Incorporation of ICG in the clinical setting may facilitate medication selection that leads to a greater proportion of patients obtaining BP control in the short term.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"916-923"},"PeriodicalIF":3.2000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials.\",\"authors\":\"Anthony J Viera, Lauren Hart, Pedro Gomez Altamirano, Brandi Tuttle, Ashley Price, Andrew Sherwood\",\"doi\":\"10.1093/ajh/hpae090\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may allow better alignment of medication with the mechanism(s) underlying an individual's hypertension. We conducted a systematic review of randomized controlled trials of ICG compared to usual care for attainment of BP control.</p><p><strong>Methods: </strong>We searched Medline inclusive of the year 1946 to January 31, 2024, using a combination of MeSH terms and keywords. English-language articles were eligible for inclusion if they described results of a randomized controlled trial designed to compare ICG-guided BP-medication selection to usual care (i.e., clinician judgment/guidelines-based alone) among a sample of hypertensive patients.</p><p><strong>Results: </strong>Of 1,952 titles screened, 6 trials met inclusion criteria. The first was published in 2002 from a specialty clinic in the United States, and the most recent in 2021 from a specialty clinic in China. One trial was conducted in a primary care setting. Sample sizes ranged from 102 to 164. Participants randomized to ICG-guided antihypertensive medication had reduced BP in the short-term to a greater extent than those randomized to usual care, with odds ratios for BP control (<140/90 mm Hg) at 3 months ranging from 1.87 to 2.92. This effect was seen in both specialty clinics and in a primary care setting.</p><p><strong>Conclusions: </strong>Incorporation of ICG in the clinical setting may facilitate medication selection that leads to a greater proportion of patients obtaining BP control in the short term.</p>\",\"PeriodicalId\":7578,\"journal\":{\"name\":\"American Journal of Hypertension\",\"volume\":\" \",\"pages\":\"916-923\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Hypertension\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ajh/hpae090\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ajh/hpae090","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

摘要

背景:由于多种因素的影响,包括降压药物的选择和滴定,血压(BP)很难得到控制。在治疗过程中使用阻抗心动图(ICG)测量血液动力学参数可以更好地根据患者高血压的发病机制调整药物。我们对 ICG 与常规治疗在控制血压方面的随机对照试验进行了系统回顾:我们使用 MeSH 术语和关键词对 Medline 进行了检索(从 1946 年到 2024 年 1 月 31 日)。只要是描述了在高血压患者样本中比较 ICG 指导下的降压药物选择与常规护理(即仅根据临床医生的判断/指南)的随机对照试验结果的英文文章均符合纳入条件:在筛选出的 1952 篇论文中,有 6 篇符合纳入标准。第一项试验发表于 2002 年,来自美国的一家专科诊所,最近一项发表于 2021 年,来自中国的一家专科诊所。有一项试验是在基层医疗机构进行的。样本量从 102 到 164 不等。与随机接受常规治疗的患者相比,随机接受 ICG 指导降压药物治疗的患者在短期内降低血压的程度更高,血压控制的几率比(结论:将 ICG 纳入临床治疗可促进药物选择,从而使更多患者在短期内获得血压控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials.

Background: Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may allow better alignment of medication with the mechanism(s) underlying an individual's hypertension. We conducted a systematic review of randomized controlled trials of ICG compared to usual care for attainment of BP control.

Methods: We searched Medline inclusive of the year 1946 to January 31, 2024, using a combination of MeSH terms and keywords. English-language articles were eligible for inclusion if they described results of a randomized controlled trial designed to compare ICG-guided BP-medication selection to usual care (i.e., clinician judgment/guidelines-based alone) among a sample of hypertensive patients.

Results: Of 1,952 titles screened, 6 trials met inclusion criteria. The first was published in 2002 from a specialty clinic in the United States, and the most recent in 2021 from a specialty clinic in China. One trial was conducted in a primary care setting. Sample sizes ranged from 102 to 164. Participants randomized to ICG-guided antihypertensive medication had reduced BP in the short-term to a greater extent than those randomized to usual care, with odds ratios for BP control (<140/90 mm Hg) at 3 months ranging from 1.87 to 2.92. This effect was seen in both specialty clinics and in a primary care setting.

Conclusions: Incorporation of ICG in the clinical setting may facilitate medication selection that leads to a greater proportion of patients obtaining BP control in the short term.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
American Journal of Hypertension
American Journal of Hypertension 医学-外周血管病
CiteScore
6.90
自引率
6.20%
发文量
144
审稿时长
3-8 weeks
期刊介绍: The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信