钙通道阻滞剂、血管紧张素转换酶/血管紧张素受体阻滞剂和利尿剂对高血压非裔美国人和非西班牙裔白种人心血管事件可能性的比较效果:一项来自HCA医疗保健的回顾性研究

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Anil Harrison, Sushil Rayamajhi, Farhad Shaker, Schwartz Thais, Melissa Moreno, Kaveh Hosseini
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引用次数: 0

摘要

背景:高血压是导致死亡和残疾的主要全球危险因素,对少数种族和族裔的影响尤为严重。我们的研究调查了既往抗高血压药物使用类型与心血管事件(CVE)可能性之间的关系,并评估患者的种族是否影响这种关系。方法:采用HCA Healthcare 2017 - 2023年的数据,对14836例年龄≥40岁的高血压患者进行回顾性研究。采用Logistic回归预测入院时CVE的可能性和死亡率,调整基线合并症,并添加种族作为效果调节因子。根据抗高血压药物类型进行种族间相互作用分析。结果:服用ACE抑制剂(ACE)或血管紧张素受体阻滞剂(ARBs)的非裔美国患者发生心血管事件(CVE)的可能性是服用钙通道阻滞剂(CCBs)的1.7倍,是服用利尿剂的0.66倍。CCB使用者的CVE风险低于利尿剂使用者。在白人患者中,ACE/ARB使用者的CVE风险比CCB使用者高1.18倍,比利尿剂低0.45倍,而CCB的风险比利尿剂低0.38倍。与白人患者相比,非裔美国人使用ACE/ARB的CVE几率明显更高,不同种族的CCBs和利尿剂的风险相似。结论:既往抗高血压类型显著影响CVE风险,种族是影响因素。CCB使用者的CVE发生率低于ACE/ arb或利尿剂,ACE/ arb与利尿剂相比,在两个种族组中均显示CVE可能性降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparative Effectiveness of Calcium-Channel Blockers, Angiotensin-Converting Enzyme/Angiotensin Receptor Blockers and Diuretics on Cardiovascular Events Likelihood in Hypertensive African-American and Non-Hispanic Caucasians: A Retrospective Study Across HCA Healthcare

Comparative Effectiveness of Calcium-Channel Blockers, Angiotensin-Converting Enzyme/Angiotensin Receptor Blockers and Diuretics on Cardiovascular Events Likelihood in Hypertensive African-American and Non-Hispanic Caucasians: A Retrospective Study Across HCA Healthcare

Background

Hypertension, a leading global risk factor for mortality and disability, disproportionately affects racial and ethnic minorities. Our study investigates the association between the type of prior antihypertensive medication use and the likelihood of cardiovascular events (CVE) and assesses whether the patient's race influences this relationship.

Methods

A retrospective study of 14 836 hypertension cases aged ≥ 40 years was conducted using data from HCA Healthcare between 2017 and 2023. Logistic regression was employed to predict the likelihood of CVE and mortality at admission, adjusting for baseline comorbidities, with Race added as an effect modifier. Interaction analysis was performed among races based on antihypertensive medication types.

Results

African American patients on ACE inhibitors (ACE) or angiotensin receptor blockers (ARBs) were 1.7 times more likely to have cardiovascular events (CVE) compared to those on calcium channel blockers (CCBs) and 0.66 times as likely compared to diuretics. CCB users had a lower CVE risk than diuretic users. Among White patients, ACE/ARB users had a 1.18 times higher CVE risk than CCB users and 0.45 times lower compared to diuretics, while CCBs offered a 0.38 times lower risk than diuretics. Only ACE/ARB use showed significantly higher CVE odds for African Americans compared to White patients, with similar risks across racial groups for CCBs and diuretics.

Conclusion

Prior antihypertensive type significantly influenced CVE risk, with race as an effect modifier. CCB users had lower CVE odds than ACE/ARBs or diuretics, and ACE/ARBs showed reduced CVE likelihood compared to diuretics in both racial groups.

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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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