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首页> 外文期刊>The journal of clinical hypertension. >Risk of Hospitalized Gastrointestinal Bleeding in Persons Randomized to Diuretic, ACE-Inhibitor, or Calcium-Channel Blocker in ALLHAT
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Risk of Hospitalized Gastrointestinal Bleeding in Persons Randomized to Diuretic, ACE-Inhibitor, or Calcium-Channel Blocker in ALLHAT

机译：ALLHAT中随机分配给利尿剂，ACEI抑制剂或钙通道阻滞剂的人住院胃肠道出血的风险

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摘要

Calcium channel blockers (CCBs) are an important class of medication useful in the treatment of hypertension. Several observational studies have suggested an association between CCB therapy and gastrointestinal (GI) hemorrhage. Using administrative databases, the authors re-examined in a post-hoc analysis whether the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants randomized to the CCB amlodipine had a greater risk of hospitalized GI bleeding (a prespecified outcome) compared with those randomized to the diuretic chlorthalidone or the angiotensin-converting enzyme inhibitor lisinopril. Participants randomized to chlorthalidone did not have a reduced risk for GI bleeding hospitalizations compared with participants randomized to amlodipine (hazard ratio [HR], 1.09; 95% confidence interval [CI], 0.92-1.28). Those randomized to lisinopril were at increased risk of GI bleeding compared with those randomized to chlorthalidone (HR, 1.16; 95% CI, 1.00-1.36). In a post-hoc comparison, participants assigned to lisinopril therapy had a higher risk of hospitalized GI hemorrhage (HR, 1.27; 95% CI, 1.06-1.51) vs those assigned to amlodipine. In-study use of atenolol prior to first GI hemorrhage was related to a lower incidence of GI bleeding (HR, 0.69; 95% CI, 0.57-0.83). Hypertensive patients on amlodipine do not have an increased risk of GI bleeding hospitalizations compared with those taking either chlorthalidone or lisinopril.
机译：钙通道阻滞剂（CCBs）是一类重要的药物，可用于治疗高血压。一些观察性研究表明CCB治疗与胃肠道（GI）出血之间存在关联。使用行政数据库，作者在事后分析中重新检查了随机分配给CCB氨氯地平的抗高血压和降脂治疗预防心脏病发作试验（ALLHAT）参与者是否有较大的住院胃肠道出血风险（预先确定的结果）与随机分配给利尿剂氯噻酮或血管紧张素转换酶抑制剂赖诺普利的患者相比。与随机接受氨氯地平的参与者相比，随机分配给氯噻酮的参与者的胃肠道出血住院风险没有降低（危险比[HR]，1.09; 95％置信区间[CI]，0.92-1.28）。与随机分配给氯噻酮的患者相比，随机分配给赖诺普利的患者发生胃肠道出血的风险更高（HR，1.16; 95％CI，1.00-1.36）。在事后比较中，与接受氨氯地平治疗的受试者相比，接受赖诺普利治疗的受试者发生胃肠道出血的风险更高（HR，1.27; 95％CI，1.06-1.51）。首次胃肠道出血之前在研究中使用阿替洛尔与胃肠道出血的发生率较低有关（HR，0.69; 95％CI，0.57-0.83）。与服用氯噻酮或赖诺普利的患者相比，氨氯地平高血压患者的胃肠道出血住院风险没有增加。

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