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2023 National Congress of the Italian Society of Hypertension (SIIA). 2023年意大利高血压学会全国代表大会。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1007/s40292-023-00604-2
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引用次数: 0
The Environmental Pollution and Cardiovascular Risk: The Role of Health Surveillance and Legislative Interventions in Cardiovascular Prevention. 环境污染与心血管风险:健康监测和立法干预在心血管预防中的作用》。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 Epub Date: 2023-12-09 DOI: 10.1007/s40292-023-00612-2
Seyedali Ghazihosseini, Carlo De Rosa, Valentina Trimarco, Raffaele Izzo, Carmine Morisco, Giovanni Esposito

Environmental pollution in considered an established determinant of non-communicable illness, including cardiovascular diseases (CVDs). Air pollution is the result of a complex combination of chemical, physical, and biological agents, and represents one of the main causes of mortality and morbidity in the world population. It is responsible for 7.6% of global mortality. In this regard, it has been documented that it increases the risk of CVDs and major adverse cardiovascular and cerebrovascular events. In northern regions of China, long-term exposures to the particulate matter < 2.5 µm (PM2.5) increase in the risk of ischemic heart disease by almost two-folds. Similarly, the additional risk for stroke, increases by almost 10% for long-term exposure to PM2.5. The detrimental effects of air pollution on cardiovascular system are particularly manifest in vulnerable subjects, such as the elderly, patients with heart disease, and obese individuals. Therefore, nowadays, cardiovascular prevention strategies, in addition to controlling traditional risk factors, should also include measures to improve the environment. This goal can be achieved by the implementation of the health surveillance in occupational medicine and by the extensive application of the national and international legislative measures. In fact, the health surveillance represents a crucial preventive measure for workers exposed to health risks (chemical, physical agents, etc.) that may lead to occupational diseases after long-term exposure. On the other hand, since environmental pollution does not recognize well-defined boundaries, only the implementation of regulations among large territorial areas can be useful to improve the quality of environment.

环境污染被认为是包括心血管疾病在内的非传染性疾病的既定决定因素。空气污染是化学、物理和生物因素复杂结合的结果,是导致世界人口死亡和发病的主要原因之一。全球 7.6% 的死亡率是由空气污染造成的。在这方面,有资料表明,它增加了心血管疾病和主要不良心脑血管事件的风险。在中国北方地区,长期暴露于小于 2.5 µm 的颗粒物(PM2.5)会使患缺血性心脏病的风险增加近两倍。同样,长期暴露于 PM2.5 中,中风的额外风险也会增加近 10%。空气污染对心血管系统的不利影响在老年人、心脏病患者和肥胖者等易感人群身上表现得尤为明显。因此,如今的心血管预防战略除了控制传统的风险因素外,还应包括改善环境的措施。这一目标可以通过在职业医学中实施健康监测以及广泛应用国家和国际立法措施来实现。事实上,对于长期暴露于可能导致职业病的健康风险(化学、物理因素等)的工人来说,健康监测是一项重要的预防措施。另一方面,由于环境污染没有明确的界限,只有在大面积区域内实施法规才能有助于改善环境质量。
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引用次数: 0
Sacubitril/Valsartan in Heart Failure with Hypertension Patients: Real-World Experiences on Different Ages, Drug Doses, and Renal Functions. 沙比利/缬沙坦治疗心力衰竭合并高血压患者:不同年龄、药物剂量和肾功能的真实世界经验。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 Epub Date: 2023-11-18 DOI: 10.1007/s40292-023-00606-0
Yingyun Guan, Xiaoye Li, Hui Li, Jinmei Ren, Kouming Tang, Chi Zhang, Zhichun Gu, Xiaoyu Li, Qianzhou Lv, Xiaolan Bian

Introduction: Hypertension is a significant risk factor in heart failure for worldwide patients. More than half of hypertensive patients suffer from heart failure. Recently, sacubitril/valsartan (sac/val) has been approved as an antihypertensive agent in China and Japan. Additionally, it is not approved for treating hypertension in Europe or the USA.

Aim: To accumulate more real-world experiences to investigate the effectiveness and optimize clinical medication of sac/val in hypertensive patients with heart failure.

Methods: We retrospectively enrolled adult patients diagnosed with hypertension (HTN) and heart failure (HF) and newly treated with sac/val. The baseline characteristics and clinical outcomes were retrospectively extracted from electronic medical records (EMR) in three centers. The efficacy and safety of sac/val were first analyzed in all enrolled patients. Stratified analyses were conducted in patients with different ages (≥ 65, < 65), maximum tolerated doses (≥ 200 mg/days, < 200 mg/days), and renal functions (e-GFR ≥ 60 ml/min/1.73 m2, < 60 ml/min/1.73 m2).

Results: Overall, 794 patients diagnosed with both HF and HTN were included in our study. During follow-up, significant reductions were found in blood pressure (BP) (SBP 12.8 ± 21.2 mmHg, P < 0.001, DBP 7.1 ± 16.5 mmHg, P < 0.001), and cardiac biomarkers (cardiac troponin 1.78 ± 19.1 ng/mL, P < 0.001, NT-proBNP 1403 ± 6937 pg/mL, P < 0.001) from baseline. In stratification analyses, the lower dosage group earned a higher BP control rate (83.4% vs. 75.6%, P = 0.025) and an overall improvement rate of cardiac indicators (61.3% vs. 48.0%, P = 0.002). The younger patients' group had significantly less cumulative hazard of recurrent cerebral-cardiovascular events than the elder group (log-rank P value < 0.001). Patients with renal dysfunction were observed with more AE incidences.

Conclusions: Sac/val could reduce BP and improve cardiac structural and functional parameters in hypertensive patients with HF, even with less than target doses. However, more attention should be paid to older patients and renal dysfunction patients when using sac/val because of additional risks in adverse events.

导读:高血压是全世界患者心力衰竭的重要危险因素。一半以上的高血压患者患有心力衰竭。最近,sacubitril/缬沙坦(sac/val)在中国和日本被批准为抗高血压药物。此外,它在欧洲或美国未被批准用于治疗高血压。目的:为探讨囊/val在高血压合并心力衰竭患者中的疗效及优化临床用药积累更多现实经验。方法:我们回顾性地招募了诊断为高血压(HTN)和心力衰竭(HF)并新近接受囊/val治疗的成年患者。回顾性地从三个中心的电子病历(EMR)中提取基线特征和临床结果。首先在所有入组患者中分析了sac/val的有效性和安全性。对不同年龄(≥65、< 65)、最大耐受剂量(≥200 mg/天、< 200 mg/天)和肾功能(e-GFR≥60 ml/min/1.73 m2, 2)的患者进行分层分析。结果:总体而言,794例诊断为HF和HTN的患者纳入了我们的研究。在随访期间,发现血压(SBP)显著降低(SBP 12.8±21.2 mmHg, P)。结论:Sac/val可降低高血压合并HF患者的血压,改善心脏结构和功能参数,即使低于目标剂量。然而,在使用sac/val时,更应注意老年患者和肾功能不全患者,因为有额外的不良事件风险。
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引用次数: 0
Echocardiographic Phenotypes of Subclinical Organ Damage: Clinical and Prognostic Value in the General Population. Findings from the Pamela Study. 亚临床器官损害的超声心动图表型:在一般人群中的临床和预后价值。帕梅拉研究的发现。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.1007/s40292-023-00610-4
Cesare Cuspidi, Andrea Faggiano, Giuseppe Mancia, Guido Grassi

Subclinical alterations in cardiac structure and function include a variety of abnormal phenotypes of established adverse prognostic significance such as left ventricular hypertrophy (LVH), alterations of LV geometry, left atrial (LA) enlargement, and aortic root (AR) dilatation. The excess cardiovascular (CV) risk associated with these phenotypes has been consistently demonstrated in different clinical settings such in patients with systemic hypertension, coronary heart disease, diabetes mellitus, chronic kidney disease, heart failure and in geneal population samples. The Pressioni Monitorate e Loro Associazioni (PAMELA), a longitudinal population-based study originally designed to assess the normality values, prognostic significance of office, home and 24-hour blood pressure, including among the many clinical and laboratory variables the collection of echocardiographic data, allowed to gather important information on the clinical prognostic significance of subclinical cardiac damage during a long follow-up period. This article summarizes the original findings provided by the PAMELA study on the clinical correlates and prognostic significance of echocardiographic markers of subclinical organa damage namely LVH, left atrial enlargement (LA) and AR dilatation at the community level.

心脏结构和功能的亚临床改变包括各种具有不良预后意义的异常表型,如左室肥厚(LVH)、左室几何形状改变、左房(LA)扩大和主动脉根(AR)扩张。与这些表型相关的过多心血管(CV)风险已在不同的临床环境中得到一致证明,例如患有全身性高血压、冠心病、糖尿病、慢性肾病、心力衰竭的患者和一般人群样本。血压监测协会(PAMELA)是一项基于人群的纵向研究,最初旨在评估办公室、家庭和24小时血压的正常值和预后意义,包括超声心动图数据收集的许多临床和实验室变量,允许在长时间随访期间收集亚临床心脏损伤的临床预后意义的重要信息。本文综述了PAMELA在社区水平上对亚临床器官损伤超声心动图指标LVH、左房扩张(LA)和AR扩张的临床相关性及预后意义的初步研究结果。
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引用次数: 0
Resistant Hypertension and Related Outcomes in a Cohort of Patients with Cardiorenal Multimorbidity Hospitalized in an Internal Medicine Ward. 在内科病房住院的心肾多病患者的顽固性高血压及其相关结局
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 Epub Date: 2023-11-27 DOI: 10.1007/s40292-023-00609-x
Antonietta Gigante, Rosario Cianci, Claudia Brigato, Michele Melena, Erika Acquaviva, Ludovica Toccini, Chiara Pellicano, Edoardo Rosato, Maurizio Muscaritoli

Introduction: Resistant hypertension (RH) is characterized by the failure to reach a goal blood pressure despite the administration of three medications at maximally tolerated doses, one of which being a diuretic. RH can be observed in a variety of clinical conditions, such as heart failure and reduced renal function and may confer high cardiovascular risk.

Aim: To evaluate the prevalence of RH and its association with clinical outcomes; the primary outcome was in-hospital mortality and the composite outcome was all-cause of mortality and morbidity in a cohort of patients with cardiorenal multimorbidity hospitalized in an internal medicine ward.

Methods: We conducted a retrospective analysis of consecutive hypertensive patients with cardiorenal multimorbidity. The composite outcome incorporated all-cause of in-hospital mortality and occurrence of sepsis, pulmonary embolism, acute coronary syndrome, stroke and renal replacement therapy.

Results: We collected data in 141 inpatients with a mean age of 77 years ± 10 (males 65.9 %), estimated glomerular filtration rate of 34 ± 18.6 ml/min with length of stay of 17 ± 12 days. The prevalence of RH was 52.4%. In-hospital mortality was observed in 24 patients (17%) and the composite outcome occurred in 87 patients (61.7%) and among these 74 (85.1%) were patients with RH. Free survival for composite outcome was significantly higher in patients without RH than patients with RH (log rank 7.52, p = 0.006). Resistant hypertension was a risk factor for composite outcome [HR 1.857(C.I. 1.170-2.946, p = 0.009)].

Conclusion: In patients with cardiorenal multimorbidity there is a high proportion of RH that represents a risk factor for composite outcome but not for in-hospital mortality.

导读:顽固性高血压(RH)的特点是,尽管以最大耐受剂量使用了三种药物,其中一种是利尿剂,但仍未能达到目标血压。RH可以在各种临床情况下观察到,如心力衰竭和肾功能下降,并可能导致心血管疾病的高风险。目的:评价RH患病率及其与临床预后的关系;主要结局是住院死亡率,复合结局是在内科病房住院的心肾多重疾病患者的全因死亡率和发病率。方法:我们对连续合并心肾多病的高血压患者进行回顾性分析。综合结果包括全因住院死亡率和脓毒症、肺栓塞、急性冠状动脉综合征、中风和肾脏替代治疗的发生。结果:我们收集了141例住院患者的资料,平均年龄为77岁±10岁(男性占65.9%),估计肾小球滤过率为34±18.6 ml/min,住院时间为17±12天。RH患病率为52.4%。住院死亡24例(17%),出现复合结局的87例(61.7%),其中RH患者74例(85.1%)。无RH患者的自由生存率显著高于RH患者(log rank 7.52, p = 0.006)。顽固性高血压是复合结局的危险因素[HR 1.857(C.I.)]1.170-2.946, p = 0.009)]。结论:在心肾多病患者中,RH的比例很高,这是复合结局的危险因素,但不是院内死亡率的危险因素。
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引用次数: 0
Psychometric Properties of a Brief Version of the Perception of Risk of Heart Disease Scale in an Italian Sample. 意大利样本中心脏病风险感知量表的心理测量特性。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-01 Epub Date: 2023-10-17 DOI: 10.1007/s40292-023-00603-3
Debora Rosa, Martino Francesco Pengo, Roberta Adorni, Grzegorz Bilo, Gianfranco Parati, Patrizia Steca

Introduction: The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high.

Aim: This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS).

Methods: PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency.

Results: Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate.

Conclusions: Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults.

引言:不知道自己患心血管疾病风险的意大利公民数量仍然很高。目的:本研究旨在翻译并初步验证心脏病风险感知量表(PRHDS)的意大利语版本。方法:PRHDS在文化上适应意大利语环境。然后,将该量表应用于772名健康成年人。通过将样本随机分为两个子样本,我们通过探索性因素分析(EFA)和验证性因素分析来测试量表维度。最后,我们评估了内部一致性。结果:量表的心理测量特性是适当的。全民教育和CFA证明了由六个项目组成的简式量表的一维结构。内部一致性是足够的。结论:意大利版的简要PRHDS是一种很有前途的自我报告问卷,用于测量意大利成年人的心血管风险感知。
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引用次数: 0
Epicardial Fat Volume as a Good Predictor for Multivessel Coronary Artery Disease. 心外膜脂肪体积是多血管冠状动脉疾病的良好预测指标。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-01 Epub Date: 2023-09-19 DOI: 10.1007/s40292-023-00590-5
Eman S El Shahawy, Asmaa A Hassan, Mohamed S El Shahawy

Introduction: Epicardial adipose tissue may have an important role in the pathogenesis of coronary artery disease (CAD).

Aim: We aimed to study the association between epicardial fat volume (EFV) and presence of obstructive as well as multivessel CAD.

Methods: A total of 87 adult subjects with suspected CAD who underwent both quantified by multidetector computerized tomography (MDCT) and Invasive Coronary Angiography (ICA) were enrolled in this observational study. EVF was measured by MDCT by calculating the sum of cross- sectional areas of fat multiplied by slice thickness. EFV measurement and its association with the presence of obstructive CAD (defined as coronary artery stenosis > 70%) was evaluated.

Results: Overall, 89.6% patients had obstructive CAD with higher EFV as compared to 10.3% patients with non-obstructive CAD (57 ± 20.14 cm3 vs. 44 ± 7.4 cm3; P < 0.001). Furthermore, EFV was significantly increased in group II as compared with group I (74 ± 24.3 ml vs. 53 ± 16.2 ml; P < 0.003). On the hand, the coronary calcium score (CAC) was insignificantly increased in group II as compared with group I (486.1 vs. 211.2; P = 0.10). Multivariate analysis revealed that, EFV might be an independent risk factor for not only the presence of obstructive CAD (odds ratio [OR], 1.062; 95% CI 1.018- 1.108; P < 0.005) but also in predicting multivessel disease affection.

Conclusions: Our results demonstrated that, EFV was significantly increased not only with obstructive CAD, independent of other traditional risk factors and CAC score, but also it can be considered a good predictor of multivessel disease occurrence.

引言:心外膜脂肪组织可能在冠状动脉疾病(CAD)的发病机制中发挥重要作用。目的:我们旨在研究心外膜脂肪体积(EFV)与梗阻性和多血管CAD之间的关系。方法:共有87名疑似CAD的成年受试者参加了这项观察性研究,他们接受了多探测器计算机断层扫描(MDCT)和有创冠状动脉造影(ICA)的量化。EVF是通过MDCT计算脂肪横截面积之和乘以切片厚度来测量的。EFV测量及其与梗阻性CAD(定义为冠状动脉狭窄)的相关性 > 70%)。结果:总体而言,89.6%的患者患有EFV较高的梗阻性CAD,而非梗阻性CAD患者为10.3%(57 ± 20.14 cm3与44 ± 7.4立方厘米;P 结论:我们的研究结果表明,EFV不仅在梗阻性CAD中显著增加,与其他传统危险因素和CAC评分无关,而且可以被认为是多血管疾病发生的良好预测指标。
{"title":"Epicardial Fat Volume as a Good Predictor for Multivessel Coronary Artery Disease.","authors":"Eman S El Shahawy,&nbsp;Asmaa A Hassan,&nbsp;Mohamed S El Shahawy","doi":"10.1007/s40292-023-00590-5","DOIUrl":"10.1007/s40292-023-00590-5","url":null,"abstract":"<p><strong>Introduction: </strong>Epicardial adipose tissue may have an important role in the pathogenesis of coronary artery disease (CAD).</p><p><strong>Aim: </strong>We aimed to study the association between epicardial fat volume (EFV) and presence of obstructive as well as multivessel CAD.</p><p><strong>Methods: </strong>A total of 87 adult subjects with suspected CAD who underwent both quantified by multidetector computerized tomography (MDCT) and Invasive Coronary Angiography (ICA) were enrolled in this observational study. EVF was measured by MDCT by calculating the sum of cross- sectional areas of fat multiplied by slice thickness. EFV measurement and its association with the presence of obstructive CAD (defined as coronary artery stenosis > 70%) was evaluated.</p><p><strong>Results: </strong>Overall, 89.6% patients had obstructive CAD with higher EFV as compared to 10.3% patients with non-obstructive CAD (57 ± 20.14 cm<sup>3</sup> vs. 44 ± 7.4 cm<sup>3</sup>; P < 0.001). Furthermore, EFV was significantly increased in group II as compared with group I (74 ± 24.3 ml vs. 53 ± 16.2 ml; P < 0.003). On the hand, the coronary calcium score (CAC) was insignificantly increased in group II as compared with group I (486.1 vs. 211.2; P = 0.10). Multivariate analysis revealed that, EFV might be an independent risk factor for not only the presence of obstructive CAD (odds ratio [OR], 1.062; 95% CI 1.018- 1.108; P < 0.005) but also in predicting multivessel disease affection.</p><p><strong>Conclusions: </strong>Our results demonstrated that, EFV was significantly increased not only with obstructive CAD, independent of other traditional risk factors and CAC score, but also it can be considered a good predictor of multivessel disease occurrence.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"427-434"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41117285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic Clinical Phenotypes of Patients with Acute Decompensated Heart Failure. 急性失代偿性心力衰竭患者的预后临床表型。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-01 Epub Date: 2023-09-05 DOI: 10.1007/s40292-023-00598-x
Tanya Mohammadi, Said Tofighi, Babak Mohammadi, Shadi Halimi, Farshad Gharebakhshi

Introduction: Acute decompensated heart failure (AHF) is a clinical syndrome with a poor prognosis.

Aim: This study was conducted to identify clusters of inpatients with acute decompensated heart failure that shared similarities in their clinical features.

Methods: We analyzed data from a cohort of patients with acute decompensated heart failure hospitalized between February 2013 and January 2017 in a Department of Cardiology. Patients were clustered using factorial analysis of mixed data. The clusters (phenotypes) were then compared using log-rank tests and profiled using a logistic model. In total, 458 patients (255; 55.7% male) with a mean (SD) age of 72.7 (11.1) years were included in the analytic dataset. The demographic, clinical, and laboratory features were included in the cluster analysis.

Results: The two clusters were significantly different in terms of time to mortality and re-hospitalization (all P < 0.001). Cluster profiling yielded an accurate discriminating model (AUC = 0.934). Typically, high-risk patients were elderly females with a lower estimated glomerular filtration rate and hemoglobin on admission compared to the low-risk phenotype. Moreover, the high-risk phenotype had a higher likelihood of diabetes type 2, transient ischemic attack/cerebrovascular accident, previous heart failure or ischemic heart disease, and a higher serum potassium concentration on admission. Patients with the high-risk phenotype were of higher New York Heart Association functional classes and more positive in their medication history.

Conclusions: There are two phenotypes among patients with decompensated heart failure, high-risk and low-risk for mortality and re-hospitalization. They can be distinguished by easy-to-measure patients' characteristics.

引言:急性失代偿性心力衰竭是一种预后不良的临床综合征。目的:本研究旨在确定具有相似临床特征的急性失代偿性心力衰竭住院患者集群。方法:我们分析了2013年2月至2017年1月在心内科住院的急性失代偿性心力衰竭患者的队列数据。使用混合数据的析因分析对患者进行聚类。然后使用对数秩检验对聚类(表型)进行比较,并使用逻辑模型进行分析。分析数据集中总共包括458名患者(255名;55.7%为男性),平均(SD)年龄为72.7(11.1)岁。聚类分析包括人口统计学、临床和实验室特征。结果:两个聚类在死亡率和再次住院时间方面存在显著差异(均P<0.001)。聚类分析产生了准确的判别模型(AUC=0.934)。通常,高危患者是老年女性,与低风险表型相比,其入院时的肾小球滤过率和血红蛋白估计值较低。此外,高危表型患2型糖尿病、短暂性脑缺血发作/脑血管意外、既往心力衰竭或缺血性心脏病的可能性更高,入院时血清钾浓度更高。具有高危表型的患者具有较高的纽约心脏协会功能分类,且其用药史更为阳性。结论:失代偿性心力衰竭患者有两种表型,即死亡和再次住院的高风险和低风险。它们可以通过易于测量的患者特征来区分。
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引用次数: 0
Risk of Arterial Hypertension After COVID-19 Recovery. COVID-19康复后动脉高血压的风险
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-01 Epub Date: 2023-08-27 DOI: 10.1007/s40292-023-00597-y
Tomoyuki Kawada
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引用次数: 0
Efficacy and Safety of Azelnidipine as an Antihypertensive Compared to Amlodipine: A Systematic Review and Meta-analysis. 与氨氯地平相比,阿泽尼地平降压的有效性和安全性:系统评价和荟萃分析。
IF 3 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-09-01 Epub Date: 2023-09-28 DOI: 10.1007/s40292-023-00601-5
Debkumar Pal, Shampa Maji, Rituparna Maiti

Introduction: Azelnidipine is one of the newer Calcium Channel Blockers (CCB) approved in China, Japan, and India. Some studies have found that the blood pressure-lowering effect of azelnidipine is more than amlodipine, and others found the effect similar.

Aim: This meta-analysis was conducted to evaluate the efficacy of azelnidipine in managing hypertensive patients by lowering Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Heart Rate (HR) as compared to amlodipine.

Methods: PubMed/MEDLINE, Google Scholar, PROQUEST, and International Clinical Trial Registry Platform (ICTRP) were searched for published articles to evaluate the clinical efficacy of azelnidipine in the management of hypertension patients. Data were extracted from the selected 11 randomized clinical trials (RCTs). The risk of bias 2 (RoB2) tool was used for the quality assessment of the included studies, and the random-effects model was used to estimate the effect size.

Results: There were no statistically significant differences in the reduction of SBP (Mean Difference, MD: - 1.07; 95% CI: - 4.10, 1.95, p-value: 0.49) and DBP (MD: 0.27; 95% CI: - 2.66, 3.20, p-value: 0.86) between both the drugs. In terms of HR reduction, there was a statistically significant difference (MD: - 3.63; 95% CI: - 5.27, - 2.00, p-value: < 0.0001) between both drugs. Egger's test excluded any publication bias for the included studies (p = 0.21). Meta-regression excluded the effect of the duration of treatment on outcome parameters.

Conclusion: Though no significant difference between azelnidipine and amlodipine was found, in terms of reduction in SBP and DBP, azelnidipine reduced heart rate significantly compared to amlodipine.

Prospero registration: CRD42023390361.

简介:阿泽尼地平是中国、日本和印度批准的新型钙通道阻滞剂之一。一些研究发现,阿泽尼地平的降压作用比氨氯地平更大,另一些研究发现效果相似。目的:本荟萃分析旨在评估与氨氯地平相比,阿泽尼地平通过降低收缩压(SBP)、舒张压(DBP)和心率(HR)来治疗高血压患者的疗效。方法:检索PubMed/MEDLINE、Google Scholar、PROQUEST和国际临床试验注册平台(ICTRP)发表的文章,评价阿泽尼地平治疗高血压患者的临床疗效。数据取自选定的11项随机临床试验(RCT)。偏倚风险2(RoB2)工具用于纳入研究的质量评估,随机效应模型用于估计效应大小。结果:SBP的降低没有统计学上的显著差异(平均差异,MD:- 1.07;95%CI:- 4.10,1.95,p值:0.49)和DBP(MD:0.27;95%置信区间:- 2.66,3.20,p值:0.86)。在HR降低方面,存在统计学显著差异(MD:- 3.63;95%CI:- 5.27- 2.00,p值:结论:虽然阿泽尼地平和氨氯地平之间没有显著差异,但在SBP和DBP的降低方面,阿泽尼平与氨氯地平相比显著降低了心率。Prospero注册号:CRD42023390361。
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引用次数: 0
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High Blood Pressure & Cardiovascular Prevention
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