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首页> 外文期刊>Hypertension: An Official Journal of the American Heart Association >Alpha-Blocker Use and the Risk of Hypotension and Hypotension-Related Clinical Events in Women of Advanced Age
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Alpha-Blocker Use and the Risk of Hypotension and Hypotension-Related Clinical Events in Women of Advanced Age

机译：α-resserer使用以及高龄妇女的低血压和低血压相关临床事件的风险

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摘要

Alpha-blockers (ABs) are commonly prescribed as part of a multidrug regimen in the management of hypertension. We set out to assess the risk of hypotension and related adverse events with AB use compared with other blood pressure (BP) lowering drugs using a population-based, retrospective cohort study of women (>= 66 years) between 1995 and 2015 in Ontario, Canada. Cox proportional hazards examined the association of AB use and hypotension and related events (syncope, fall, and fracture) compared with other BP lowering drugs matched via a high dimensional propensity score. The primary outcome was a composite of hospitalizations for hypotension and related events (syncope, fractures, and falls) within 1 year. From 734 907 eligible women, 14 106 were dispensed an AB (mean age, 75.7; standard deviation 6.9 years, median follow-up 1 year) and matched to 14 106 dispensed other BP lowering agents. The crude incidence rate of hypotension and related events was 95.7 (95% CI [confidence interval], 90.4-101.1, events 1214 [8.6%]) with AB and 79.8 (95% CI, 74.9-84.7 per 1000 person-years, events 1025 [7.3%]) with other BP lowering medications (incident rate ratio, 1.20; 95% CI, 1.10-1.30). The risk was higher for hypotension (hazard ratio, 1.71; 95% CI, 1.33-2.20) and syncope (hazard ratio, 1.44; 95% CI, 1.18-1.75) with no difference in falls, fractures, adverse cardiac events, or all-cause mortality. Treatment of hypertension in women with ABs is associated with a higher risk of hypotension and hypotension-related events compared with other BP lowering agents. Our findings suggest that ABs should be used with caution, even as add on therapy for hypertension.
机译：α-受体阻滞剂（ABS），通常规定为在高血压的管理多药方案的一部分。我们的目标是评估低血压的风险和相关的不良事件与AB使用与其他血压（BP）相比，在安大略省1995年至2015年间降低使用人口为基础的回顾性队列妇女的研究（> = 66岁）的药物，加拿大。 Cox比例风险检查经由高维倾向得分匹配其他降低血压药物相比AB使用和低血压和相关事件（晕厥，秋天，和断裂）的关系。主要成果是一个复合住院低血压及相关事件（晕厥，骨折和跌倒）1年以内。从734周907符合条件的妇女，14 106分装的AB（平均年龄75.7;标准偏差6.9年，中位随访1年），并匹配到14 106分配等降低血压药。低血压和相关事件的粗发病率为95.7（95％CI [置信区间]，90.4-101.1，事件1214 [8.6％]）与AB和79.8（95％CI，74.9-84.7每1000人 - 年，事件1025 [7.3％]）与其他降低血压药物（发生率比率，1.20; 95％CI，1.10-1.30）。的风险较高低血压（风险比，1.71; 95％CI，1.33-2.20）和晕厥（风险比，1.44; 95％CI，1.18-1.75），在下降时，骨折无差异，不良心脏事件，或者所有-cause死亡率。在妇女与AB类治疗高血压与低血压及低血压相关事件的高风险与其他降血压药物相比有关。我们的研究结果表明，AB类应谨慎使用，即使添加上治疗高血压。

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