肾素-血管紧张素系统阻滞剂和二氢吡啶类钙离子拮抗剂对高血压患者甲状旁腺素水平的影响

Effect of renin-angiotensin system inhibitors and dihydropyridine calcium channel blocker on parathyroid hormone levels in hypertensive patients

目的研究肾素-血管紧张素系统阻滞剂(RASI)、二氢吡啶类钙离子拮抗剂(CCB)单药治疗对高血压患者PTH水平的影响。方法邀请某工厂所有职工参与心血管风险调查,共1420例参加本研究,其中178例高血压患者正在接受降压治疗。其中90例为单药治疗。90例中60例使用CCB,18例使用RASI。分别分析RASI、CCB单药治疗对PTH水平的影响。结果在校正性别、年龄、肾小球滤过率和25(OH)D后,RASI使用者和非RASI使用者相比,PTH水平相对较低(23.9 pg/ml vs.36.4 pg/ml,P=0.03)。CCB使用者与非CCB使用者相比,PTH水平有升高趋势,但差异无统计学意义(35.2 pg/ml vs.31.2 pg/ml,P=0.36)。结论使用肾素-血管紧张素系统阻滞剂可能降低高血压患者的PTH水平,在降压的同时有利于骨骼健康。

Objective To study the effects of renin-angiotensin system blocker(RASI)and dihydropyridine calcium antagonist(CCB)on PTH levels in hypertensive patients.Methods Workers of a factory were invited to participate in the investigation focus on cardiovascular risk.A total of 1420 participants were enrolled in the present analyses.178 hypertensive patients were under antihypertensive treatment,and 90 patients were under single-drug treatment.Of the 90 patients,60 were treated with CCB,18 with RASI.The effects of RASI and CCB on PTH levels were analyzed.Results After adjusting for sex,age,glomerular filtration rate and 25(OH)D,PTH levels in RASI users were significantly lower than that in non-RASI users(23.9 pg/ml vs.36.4 pg/ml,P=0.03).PTH levels in CCB users were higher than that in non-CCB users,but the difference was not statistically significant(35.2 pg/ml vs.31.2 pg/ml,P=0.36).Conclusion The use of renin-angiotensin blocker can reduce the PTH levels,which might be beneficial to bone health.