受体阻滞剂对老年人静息呼吸率的影响:一项横断面研究

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics Pub Date : 2023-02-01 DOI:10.1016/j.pupt.2022.102186

Atsushi Takayama , Takashi Yoshioka , Takahiko Nagamine

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引用次数: 0

摘要

[目的]-受体阻滞剂，通常用于老年人，影响心率和血压，并可能降低呼吸频率，用于评估患者状态和预测预后。然而，有限的临床证据表明-受体阻滞剂对呼吸频率的影响。本研究旨在探讨-受体阻滞剂对老年人呼吸频率的影响。[方法]本横断面研究纳入年龄≥60岁且每年进行体检的患者。如果诊断为严重心力衰竭、慢性阻塞性肺病、间质性肺炎、严重贫血或神经退行性疾病，则排除患者。采用逆概率加权的双稳健估计来估计受体阻滞剂使用者和非使用者之间的平均差异。使用多变量回归模型检验了受体阻滞剂与呼吸频率之间的剂量-反应关系。[结果]637名参与者中，108人定期接受受体阻滞剂治疗。受体阻滞剂使用者和非使用者在呼吸频率、脉搏频率、收缩压和舒张压方面的调整平均差异(95%置信区间，CI)分别为0.35(- 0.68至1.37)、- 3.56(- 6.34至- 0.78)、- 5.53(- 8.53至- 2.52)和- 4.70(- 8.27至- 1.14)。在所有β受体阻滞剂使用者、脂溶性β受体阻滞剂使用者和卡维地洛使用者中，每1mg卡维地洛等效剂量呼吸速率的调整平均差异(95% CI)分别为- 0.10(- 0.18至- 0.02)、- 0.35(- 0.59至- 0.11)和- 0.29(- 0.54至- 0.06)。[结论]受体阻滞剂可剂量依赖性地降低老年人的呼吸频率。然而，在临床环境中，使用或不使用-受体阻滞剂对呼吸速率的影响可能不会达到临床重要水平。临床医生应根据情况注意-受体阻滞剂对呼吸频率的潜在抑制作用。

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Impact of beta blockers on resting respiratory rate in older adults: A cross-sectional study

[Purpose] Beta blockers, commonly prescribed for older adults, affect heart rates and blood pressure and may reduce respiratory rates, which are used to evaluate patient status and predict outcomes. However, limited clinical evidence is available on the impact of beta blockers on respiratory rates. This study aimed to investigate the impact of beta blockers on respiratory rates in older adults.

[Methods] This cross-sectional study included patients aged ≥60 years who underwent an annual checkup. Patients were excluded if they had a diagnosis of severe heart failure, chronic obstructive pulmonary disease, interstitial pneumonitis, severe anemia, or neurodegenerative disease. Doubly robust estimation with inverse probability weighting was applied to estimate the mean differences between beta blocker users and non-users. The dose-response relationship between the administered beta blockers and respiratory rates was examined using multivariable regression models.

[Results] Of 637 participants, 108 had received beta blockers regularly. The adjusted mean differences (95% confidence interval, CI) in respiratory rates, pulse rates, systolic blood pressure, and diastolic blood pressure between beta blocker users and non-users were 0.35 (−0.68 to 1.37), −3.56 (−6.34 to −0.78), −5.53 (−8.53 to −2.52), and −4.70 (−8.27 to −1.14), respectively. The adjusted mean differences (95% CI) in respiratory rates per 1 mg of a carvedilol equivalent dose in all beta blocker users, liposoluble beta blocker users, and carvedilol users were −0.10 (−0.18 to −0.02), −0.35 (−0.59 to −0.11), and −0.29 (−0.54 to −0.06), respectively.

[Conclusions] Beta blockers may dose-dependently reduce the respiratory rates of older adults. However, in clinical settings, the impact of beta-blocker use or non-use on the respiratory rate may not occur at a clinically important level. Clinicians should note the potentially suppressive impact of beta blockers on respiratory rates according to the situation.

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来源期刊

Pulmonary pharmacology & therapeutics 医学-呼吸系统

CiteScore

6.20

自引率

0.00%

发文量

审稿时长

42 days

期刊介绍： Pulmonary Pharmacology and Therapeutics (formerly Pulmonary Pharmacology) is concerned with lung pharmacology from molecular to clinical aspects. The subject matter encompasses the major diseases of the lung including asthma, cystic fibrosis, pulmonary circulation, ARDS, carcinoma, bronchitis, emphysema and drug delivery. Laboratory and clinical research on man and animals will be considered including studies related to chemotherapy of cancer, tuberculosis and infection. In addition to original research papers the journal will include review articles and book reviews. Research Areas Include: • All major diseases of the lung • Physiology • Pathology • Drug delivery • Metabolism • Pulmonary Toxicology.