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培哚普利降压治疗可降低心房纤颤及以前有卒中或短暂缺血性发作患者大血管事件的发生
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作者 Arima H. Hart R.G. +2 位作者 colman s. J. Chalmers 牛亚利 《世界核心医学期刊文摘(神经病学分册)》 2006年第3期44-45,共2页
Background and Purpose -Patients with atrial fibrillation have a high risk of stroke and other vascular events even if anticoagulated. The primary objective here is to determine whether routine blood pressure-lowering... Background and Purpose -Patients with atrial fibrillation have a high risk of stroke and other vascular events even if anticoagulated. The primary objective here is to determine whether routine blood pressure-lowering provides additional protection for this high-risk patient group. Methods -This study was a subsidiary analysis of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS)-a randomized, placebocontrolled trial that established the beneficial effects of blood pressure-lowering in a heterogeneous group of patients with cerebrovascular disease. A total of 6105 patients were randomly assigned to either active treatment (2 to 4 mg perindopril for all participants plus 2.0 to 2.5 mg i ndapamide for those without an indication for or a contraindication to a diuretic) or matching placebo(s). Outcomes are total major vascular events, causespecific vascular outcomes, and death from any cause. Results -There were 476 patient s with atrial fibrillation at baseline, of whom 51%were taking anticoagulants. In these patients, active treatment lowered mean blood pressure by 7.3/3.4 mm Hg and was associated with a 38%(95%confidence interval [CI], 6 to 59) reduction in major vascular eve nt s and 34%(95%CI, -13 to 61) reduction in stroke. The benefits of blood pressu re-lowering in patients with atrial fibrillation were achieved irrespective of the use of anticoagulant therapy (P homogeneity=0.8) or the presence of hyperten sion (P homogeneity=0.4). Conclusions -For most patients with atrial fibrillati on, routine blood pressurelowering is likely to provide protection against major vascular events additional to that conferred by anticoagulation. 展开更多
关键词 心房纤颤 培哚普利 吲达帕胺 全因死亡 预后指标 患者群体 安慰剂对照 卒中发生率 脑血管疾病 辅助
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