氢氯噻嗪相关皮肤癌风险的地域差异与高血压心脏病相关残疾的平衡。

IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Anders Almskou Rasmussen, Niels Henrik Buus, Simon G Comerma Steffensen
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引用次数: 0

摘要

背景:高血压影响着全球25%-30%的人口。氢氯噻嗪(HCTZ)是最常用、最廉价的药物之一,但在2018年却被贴上了警告标签,指出其会增加罹患非黑素瘤皮肤癌(NMSC)的风险。本研究从高血压性心脏病(HHD)的角度描述了HCTZ与非黑素瘤皮肤癌之间关联的地域差异:我们使用 PICO/PECO 首字母缩写进行了系统性文献检索(PubMed、Embase、Clinicaltrial.gov 和 Clinicaltrial.eu),包括病例对照、队列和随机对照试验。我们在全球疾病负担(GBD)地区构建了HHD/NMSC的残疾调整生命年(DALY)比率:结果:在台湾、印度和巴西,使用 HCTZ 不会增加罹患 NMSC 的风险。加拿大、美国和韩国的风险较小(危险比 (HR)/ds ratio (OR) ≤ 1.5),但显著增加。冰岛、西班牙和日本的风险增加(1.5
2.5)。在 21 个 GBD 地区中,有 13 个地区的 HHD DALY 率是 NMSC 的 10 倍以上,占全球人口的 77.2%。在这 13 个地区中,没有一个地区的 HCTZ 相关 NMSC 风险增加:结论:尽管来自许多国家的信息有限,但我们的数据表明,HCTZ与NMSC之间的关联存在巨大的地域差异。在除澳大拉西亚以外的所有 GBD 地区,与 NMSC 相比,HHD 造成的残疾调整寿命损失率超过 5 倍。在避免将 HCTZ 作为降压治疗的一部分之前,应考虑到这种不成比例的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease.

Background: Hypertension affects 25%-30% of the world population. Hydrochlorothiazide (HCTZ) is among the most used and cheapest medications but was in 2018 labeled with a warning stating the increased risk of nonmelanoma skin cancer (NMSC). This study describes geographical differences in the association between HCTZ and NMSC from the perspective of hypertensive heart disease (HHD).

Methods: We conducted a systematic literature search (PubMed, Embase, Clinicaltrial.gov, and Clinicaltrial.eu) using PICO/PECO acronyms, including case-control, cohort, and randomized controlled trials. We constructed a rate ratio of disability-adjusted life years (DALY) for HHD/NMSC in the global burden of disease (GBD) regions.

Results: No increased risk of NMSC with the use of HCTZ was found in Taiwan, India, and Brazil. A small (hazard ratio (HR)/odds ratio (OR) ≤1.5) but significantly increased risk was seen in Canada, the United States, and Korea. An increased risk (1.5< HR/OR ≤2.5) in Iceland, Spain, and Japan and a highly increased risk (HR/OR >2.5) in the United Kingdom, Denmark, the Netherlands, and Australia. HHD is associated with a more than tenfold DALY rate compared with NMSC in 13 of 21 GBD regions, corresponding to 77.2% of the global population. In none of these 13 regions was there an increased risk of HCTZ-associated NMSC.

Conclusions: Despite limited information from many countries, our data point to large geographical differences in the association between HCTZ and NMSC. In all GBD regions, except Australasia, HHD constitutes a more than fivefold DALY rate compared to NMSC. This disproportionate risk should be considered before avoiding HCTZ from the antihypertensive treatment.

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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.
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