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Dołączył: 21 Lut 2011
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 Wysłany: Nie 7:01, 06 Mar 2011 Temat postu: tory burch rke opd fabz ies |
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ALLHAT study findings and arguments?
10 documents listed, ABPM used only during the day manometry large. The results of these MH patients with clinical manometry manometry night (also at night) different? 5. MH prognosis how? Year review report of white coat hypertension, white coat hypertension was considered in determining the prognosis of hypertension results of a controversial ALLHAT study? Recently completed an American Institute of Health the number of patients up to 33,000 people blood pressure lowering to prevent heart attack study (Antihy-pertensionandLipidLoweringTreatmenttoPreventHeartAttackTrial, ALLHAT). Most of these high-risk hypertensive patients, aged> 55 years old, I ~ Ⅱ of high blood pressure,[link widoczny dla zalogowanych], 1 to 2 or more risk factors,[link widoczny dla zalogowanych], including previous MI,[link widoczny dla zalogowanych], stroke, L,, diabetes,[link widoczny dla zalogowanych], smoking,[link widoczny dla zalogowanych], HDL-C < 35mg%. ALLHAT compared a diuretic (chlorthalidone), calcium antagonist (amlodipine), angiotensin converting enzyme inhibitor (lisinopril), n blocker (doxazosin) and other four drugs on the prevention of heart Vascular complications, efficacy, follow-up of 5 years. In 2000, the efficacy of doxazosin for poor, to stop the study early. The main conclusions are: 1. The group of drugs for fatal coronary heart disease myocardial infarction and non-fatal myocardial infarction was no difference between the preventive effect, no differences in total mortality. 2. L secondary outcomes in the incidence of heart failure, chlorthalidone group than in the low-calcium antagonist; stroke incidence, chlorthalidone group were lower than the ACEI lisinopril. 3. As long as the appropriate treatment can be achieved compliance in 60% of the patients blood pressure SBP <140/90mmHg. Generally required 2 to 3 antihypertensive drugs. 4. Diuretics compared with other new antihypertensive drugs, the effect is not bad, side effects were not evident. Added minor side effects such as diabetes and hypokalemia. Compared with the total effect, side effects cause for concern. 5. Long-acting calcium antagonists equally effective, unlike in the past, some reports that this or that side effects (such as increased myocardial infarction, etc.). ALLHAT study was published, the author made the conclusion I This conclusion led to a protest. Different views mainly: like. Now follow-up report that the prognosis of white coat hypertension and normal subjects similar. Census of hypertension in China has nearly 1 million people suffer from high blood pressure. We should conscientiously do so, which should be about 10% of the white-coat hypertension removed, it should be about 5% to 10% was added to cover the high blood pressure. Generally, the incidence of hypertension in China how many per cent may be accurate enough. (1) The fact of death in each group and non-fatal myocardial infarction was no different. Diuretics only in certain subgroups of patients, such as heart failure, stroke side effects than other drugs significantly. (2) The study design limitations, ACEI did not give full play to the superiority. Because of design requirements, first with the first line drug chlorthalidone 25rng / d, lisinopril 40rng / d, amlodipine 10rng / d. If you use this dose, blood pressure is not standard, you can use second-line drugs. Include: reserpine, clonidine, Atenolol, hydralazine. If the first line of chlorthalidone used, second-line coupled with Atenolol, of course, is a very good combination. But the first line with ACEI, blood pressure, if not standard, the best plus diuretic. The experimental design does not allow, can only use reserpine and other, this combination of course far from ideal, the antihypertensive effect of the natural poor. (3) in the treatment of hypertension patients should be based on patient For example, a diabetic patient with hypertension, the doctor first, Or is coming up at the same time with 6I + diuretics, or ARB + diuretic. A past heart attack or heart failure in hypertensive patients to clinics, the first or diuretics, and diuretics should be used with the use of 8-blocker. (4) If a patient had used other antihypertensive drugs, the effect is good, blood pressure has dropped to 120/80mmHg, it would not have to diuretics, continue to use the drug on it. In summary, ALLHAT study gives people a good result: thiazide diuretics are a good blood pressure drugs, more effective, in the case of small doses (two grams: 6.25rng / d ~ 12.5rng / d ) side effects are minor. Can be used in conjunction with a variety of antihypertensive drugs, should vigorously promote the use of clinical practice.
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