一些降压药可能会增加血压, 而其他人则更低, heart risks in people with HIV

针对艾滋病毒携带者和高血压患者, the type of medication used to lower their blood pressure may impact future cardiovascular risk, 新的研究表明.

这项研究于周一发表 发表在美国心脏协会杂志《线上娱乐电子游戏网站》上, found certain blood pressure medications increased the risk for heart disease, stroke or heart failure 而其他人则更低ed the risk of heart failure in a group of mostly male veterans.

With current anti-retroviral medications, people with HIV are able to live longer. 然而, people taking these medications are more likely to develop high blood pressure and related heart problems than people in the general population. This is the first large-scale study to examine how the choice of blood pressure medication influences the long-term risk of heart disease, 艾滋病和高血压患者的中风和心力衰竭.

研究人员回顾了8个州的记录,041 veterans with HIV who developed high blood pressure between 2000 and 2018. 作为第一种治疗, 13% were prescribed beta blockers; 24% were started with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs); 23% were given thiazide or similar diuretics; and 11% were prescribed calcium channel blockers (CCBs).

Participants without heart disease at the beginning of the study who were prescribed beta blockers had a 90% higher risk of developing heart disease, 心力衰竭或中风期间平均6.比服用ACE抑制剂或arb的患者随访5年, 即使他们的血压控制得很好. 噻嗪类利尿剂和CCBs不增加风险.

无慢性肾脏疾病的参与者, taking ACE inhibitors or ARBs was associated with a lower risk of heart failure compared to taking other blood pressure medications, 哪一种会使患心力衰竭的风险增加50%.

该研究的资深作者Dr. Jordana Cohen said in a news release the choice of blood pressure medication participants were prescribed could have varied due to potential drug interactions with HIV medications. Cohen is an assistant professor of medicine and epidemiology in the renal-electrolyte and hypertension division at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

“另外, 比如身体如何处理盐, inflammation and the accelerated aging of blood vessels may affect the risk of cardiac events in people with HIV differently than people who do not have HIV, 使用哪种降压药会影响哪一个,她说.

Cohen said it was unusual to find such high use of beta blockers since they are not typically recommended as the first line of treatment for high blood pressure.

"We suspect this may be due to the fact that many people with HIV receive primary care from their infectious disease team, who do an amazing job at managing HIV but may not be focused on blood pressure treatment guidelines and contraindications,科恩说. “理想情况下, a patient's primary care and infectious disease teams work together for the best possible outcomes."

Cohen said the results also highlight possible harm from using beta blockers as first-line treatment for hypertension whether a person has HIV or not.

"While many people are appropriately treated with beta blockers for various reasons,她说, "if you think you are taking them only for hypertension and aren't on any other blood pressure medications, I'd recommend talking to your doctor to make sure it's the best medication for you."

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