Discontinuation of Antihypertensive Drugs Due to Adverse Events: A Systematic Review and Meta-analysis
作者:Susan D. Ross、Kasem S. Akhras、Shuhuan Zhang、Michael Rozinsky、Luba Nalysnyk
DOI:10.1592/phco.21.11.940.34520
日期:2001.8
We conducted a systematic review of randomized, controlled, monotherapy trials since 1990 of oral antihypertensive agents in patients with essential hypertension. Our objective was to quantify the frequency of discontinuation of antihypertensive agents due to adverse events from a meta-analysis of the studies. A total of 190 studies met inclusion criteria. The highest frequency of discontinuations due to adverse events (DAEs) occurred with calcium channel blockers (6.7%) and α-adrenergic blockers (6.0%); the lowest with diuretics and angiotensin receptor blockers (each 3.1%). Only in calcium channel blocker studies was the frequency of DAEs greater in treated patients than in patients receiving placebo, but the difference was not significant. This systematic review suggests that the frequency of DAEs in monotherapy antihypertensive trials varies across drug classes and should be considered when choosing drugs for patients with essential hypertension.
我们对自 1990 年以来口服降压药治疗原发性高血压患者的随机、对照、单一疗法试验进行了系统评价。我们的目标是通过研究荟萃分析来量化因不良事件而停用抗高血压药物的频率。共有 190 项研究符合纳入标准。因不良事件 (DAE) 停药的频率最高的是钙通道阻滞剂 (6.7%) 和 α-肾上腺素能阻滞剂 (6.0%);利尿剂和血管紧张素受体阻滞剂的比例最低(各 3.1%)。仅在钙通道阻滞剂研究中,治疗患者的 DAE 频率高于接受安慰剂的患者,但差异并不显着。这项系统评价表明,单药治疗抗高血压试验中 DAE 的发生频率因药物类别而异,在为原发性高血压患者选择药物时应予以考虑。