钙通道阻滞剂在重度主动脉瓣狭窄和高血压患者中的安全性。

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Journal Pub Date : 2024-12-18 DOI:10.1253/circj.CJ-24-0771

Ko Yamamoto, Yasuaki Takeji, Tomohiko Taniguchi, Takeshi Morimoto, Shinichi Shirai, Takeshi Kitai, Hiroyuki Tabata, Nobuhisa Ohno, Ryosuke Murai, Kohei Osakada, Koichiro Murata, Masanao Nakai, Hiroshi Tsuneyoshi, Tomohisa Tada, Masashi Amano, Shin Watanabe, Hiroki Shiomi, Hirotoshi Watanabe, Yusuke Yoshikawa, Ryusuke Nishikawa, Yuki Obayashi, Mamoru Toyofuku, Shojiro Tatsushima, Norio Kanamori, Makoto Miyake, Hiroyuki Nakayama, Kazuya Nagao, Masayasu Izuhara, Kenji Nakatsuma, Moriaki Inoko, Takanari Fujita, Masahiro Kimura, Mitsuru Ishii, Shunsuke Usami, Fumiko Nakazeki, Kiyonori Togi, Yasutaka Inuzuka, Kenji Ando, Tatsuhiko Komiya, Koh Ono, Kenji Minatoya, Takeshi Kimura

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引用次数: 0

摘要

背景：关于钙通道阻滞剂（CCB）在严重主动脉狭窄（AS）和高血压患者中的安全性的数据缺乏。方法和结果：在当前AS登记的2460例接受降压治疗的严重AS合并高血压患者中，我们比较了接受CCB （CCB组）和不接受CCB（无CCB组）降压治疗的患者的临床结果。在整个研究人群中，1763名患者（71.7%）服用了CCB，这是最常用的抗高血压药物。CCB组血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂、受体阻滞剂、噻嗪类药物的处方率分别为61.9%、25.6%、7.3%，无CCB组为75.8%、54.4%、6.0%。在倾向评分匹配的队列中，CCB组和无CCB组的累积3年全因死亡或心力衰竭住院发生率无差异(38.3% vs 38.7%, log-rank P=0.65；人力资源,0.94;95%置信区间,0.77 - -1.15;P = 0.56)。无论CCB处方如何，累计3年晕厥发生率均较低（1.1% vs. 1.0%， P=0.74）。结论：在严重AS合并高血压患者中，CCB是最常用的降压药，加用CCB的降压治疗与不加用CCB的降压治疗的临床结果相当。不论CCB处方如何，在接受降压治疗的严重AS和高血压患者中很少见到晕厥。

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Safety of Calcium Channel Blockers in Patients With Severe Aortic Stenosis and Hypertension.

Background: There is a paucity of data on safety of calcium channel blockers (CCB) in patients with severe aortic stenosis (AS) and hypertension.

Methods and results: Among 2,460 patients with severe AS and hypertension receiving antihypertensive therapy in the CURRENT AS registry-2, we compared the clinical outcomes between patients taking antihypertensive therapy with CCB (CCB group) and without CCB (no CCB group). In the entire study population, CCB was prescribed in 1,763 patients (71.7%), which was the most commonly prescribed antihypertensive agents. The prescription rates of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and thiazides were 61.9%, 25.6%, and 7.3% in the CCB group, and 75.8%, 54.4%, and 6.0% in the no CCB group. In the propensity score matched cohort, the cumulative 3-year incidence of all-cause death or hospitalization for heart failure was not different between the CCB and no CCB groups (38.3% vs. 38.7%, log-rank P=0.65; HR, 0.94; 95%CI, 0.77-1.15; P=0.56). The cumulative 3-year incidence of syncope was low regardless of CCB prescription (1.1% vs. 1.0%, P=0.74).

Conclusions: Among patients with severe AS and hypertension, CCB was the most commonly prescribed antihypertensive agents, and antihypertensive therapy with CCB was associated with comparable clinical outcomes to antihypertensive therapy without CCB. Syncope was rarely seen in patients with severe AS and hypertension receiving antihypertensive therapy regardless of CCB prescription.

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来源期刊

Circulation Journal 医学-心血管系统

CiteScore

5.80

自引率

12.10%

发文量

471

审稿时长

1.6 months

期刊介绍： Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.