药物负担和抗胆碱能药物的使用与肝硬化患者明显的高血压有关。

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2024-07-22 eCollection Date: 2024-08-01 DOI:10.1097/HC9.0000000000000460
Jonathan A Montrose, Archita Desai, Lauren Nephew, Kavish R Patidar, Marwan S Ghabril, Noll L Campbell, Naga Chalasani, Yingjie Qiu, Matthew E Hays, Eric S Orman
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引用次数: 0

摘要

背景:多重用药和抗胆碱能药物与老年人认知能力下降有关。虽然有几种药物与高血压有关,但尚未探讨药物负担、抗胆碱能药物与高血压之间的关系。我们研究了肝硬化患者的用药负担和抗胆碱能药物,以及它们与肝硬化相关住院治疗的关系:我们对 2019 年期间在肝病诊所就诊的 18-80 岁肝硬化患者进行了一项回顾性队列研究。研究记录了慢性药物的数量(药物负担)和抗胆碱能药物的使用情况。主要结果是与肝病相关的住院治疗:共对 1039 名患者进行了中位数为 840 天的随访。37%的患者有高血压病史,9.8%的患者在随访期间出现过与高血压相关的住院治疗。慢性药物的平均数量为 6.1 ± 4.3。在单变量模型(HR:1.09,95% CI:1.05-1.12)和多变量模型(HR:1.07,95% CI:1.03-1.11)中,药物负担的增加与高血压相关住院治疗有关。这种关系在基线高血压患者中保持不变,但在无基线高血压患者中则没有。21%的人正在服用抗胆碱能药物。在单变量模型(HR:1.68,95% CI:1.09-2.57)和多变量模型(HR:1.71,95% CI:1.11-2.63)中,抗胆碱能药物暴露与 HE 相关住院率增加有关。这种关系在基线高血压患者中得以维持,而在无基线高血压患者中则无法维持:结论:抗胆碱能药物的使用和用药负担都与高血压相关的住院治疗有关,尤其是在有高血压病史的患者中。应该对限制抗胆碱能药物和尽量减轻总体用药负担的特殊考虑因素进行测试,以确定其在这一人群中的潜在益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medication burden and anticholinergic use are associated with overt HE in individuals with cirrhosis.

Background: Polypharmacy and anticholinergic medications are associated with cognitive decline in elderly populations. Although several medications have been associated with HE, associations between medication burden, anticholinergics, and HE have not been explored. We examined medication burden and anticholinergics in patients with cirrhosis and their associations with HE-related hospitalization.

Methods: We conducted a retrospective cohort study of patients aged 18-80 with cirrhosis seen in hepatology clinics during 2019. The number of chronic medications (medication burden) and anticholinergic use were recorded. The primary outcome was HE-related hospitalization.

Results: A total of 1039 patients were followed for a median of 840 days. Thirty-seven percent had a history of HE, and 9.8% had an HE-related hospitalization during follow-up. The mean number of chronic medications was 6.1 ± 4.3. Increasing medication burden was associated with HE-related hospitalizations in univariable (HR: 1.09, 95% CI: 1.05-1.12) and multivariable (HR: 1.07, 95% CI: 1.03-1.11) models. This relationship was maintained in those with baseline HE but not in those without baseline HE. Twenty-one percent were taking an anticholinergic medication. Anticholinergic exposure was associated with increased HE-related hospitalizations in both univariable (HR: 1.68, 95% CI: 1.09-2.57) and multivariable (HR: 1.71, 95% CI: 1.11-2.63) models. This relationship was maintained in those with baseline HE but not in those without baseline HE.

Conclusions: Anticholinergic use and medication burden are both associated with HE-related hospitalizations, particularly in those with a history of HE. Special considerations to limit anticholinergics and minimize overall medication burden should be tested for potential benefit in this population.

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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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