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背景不同种类的抗高血药可改变房颤的风险。有些研究提出,病人可从某些干扰肾素-血管紧张素系统药物的心房重构作用中受益。目的 对使用不同抗高血压药的病人发生房颤的相关风险做评估和对照。设计巢式病例对照研究。设施英国联合王国-全科医学研究数据库,初级保健数据库,含有近500万病人记录。病人682993例病人接受高血压治疗,4661例房颤和18642例病人作为对照参试者。测量对血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体阻滞剂(ARBs)和β-受体阻滞剂使用者与参照组钙通道阻滞剂使用者发生房颤风险做了对照。排除了有房颤临床风险因素的病人。结果与长期单用钙通道阻滞剂相比,长期单用ACEI[OR=0.75,95%CI为(0.65,0.87)]、ARBs[OR=0.71,95%CI为(0.57,0.89)]或β-受体阻滞剂[OR=0.78,95%CI为(0.67,0.92)]发生房颤的风险要低。限度 4治疗过程未能观察血压变化,一项观察研究不能完全排除效果偏倚风险。结论与钙通道阻滞剂相比,高血压病人长期用ACEI、ARBs或β-受体阻滞剂使房颤风险降低。
Background Different kinds of anti-hyperglycemia can change the risk of atrial fibrillation. Some studies suggest that patients may benefit from some atrial remodeling that interferes with renin-angiotensin system drugs. Objective To assess and compare the risk associated with atrial fibrillation in patients with different antihypertensives. Design a nested case-control study. Facilities United Kingdom United Kingdom - General Medical Research Database, Primary Health Database, with nearly 5 million patient records. Six hundred and eighty-nine patients were treated with hypertension, 4661 with atrial fibrillation and 18642 patients as controls. Measure the risk of developing atrial fibrillation in users of ACE inhibitors, ARBs and beta-blockers, and users of the reference calcium channel blocker Control. Ruled out patients with clinical risk factors for atrial fibrillation. Results Compared with long-term calcium channel blocker alone, long-term ACEI alone [OR = 0.75, 95% CI (0.65,0.87)], ARBs [OR = 0.71, 95% CI (0.57, 0.89)] or β-blockers [OR = 0.78, 95% CI (0.67, 0.92)] had a lower risk of atrial fibrillation. Limit 4 The course of treatment failed to observe changes in blood pressure, an observational study can not completely rule out the risk of bias. Conclusion Compared with calcium channel blockers, long-term use of ACE inhibitors, ARBs or β-blockers in patients with hypertension reduce the risk of atrial fibrillation.