中国临床药学杂志2005，Vol.14Issue(4)：214-219,6.
老年糖尿病人群低血糖风险和抗高血压药物应用的队列研究
Antihypertensives and risk of hypoglycemia in elderly hypertensive diabetic patients using antidiabetic drugs
汤文璐 1王永铭 2杜文民 3程能能 2陈斌艳2
作者信息
- 1. 上海交通大学药学院药理实验室,上海,200030
- 2. 复旦大学药学院药理学教研室,上海,200032
- 3. 上海市药品不良反应检测中心,上海,200040
- 折叠
摘要
Abstract
AIM To determine the relationship between antihypertensives and the risk of hypoglycemia in elderly hypertensive diabetic patients using antidiabetics. METHODS We conducted a population-based, retrospective cohort study of 1 324 hypertensive patients with elderly diabetes mellitus (DM) who were selected from a database of the monitoring system for antidiabetic drugs in elderly diabetic population from five administrative areas in Shanghai and used the antidiabetics between 2001 June and 2002 June. The observational end point was hypoglycemia definitely diagnosed in hospitals. Descriptive statistical methods and Poisson regression model including multi-covariables were also used to identify the rates and the adjusted relative risk (RR) of hypoglycemia relating to antihypertensives. RESULTS We identified 34 persons with a first episode of hypoglycemia during the study period. The crude rate of hypoglycemia among antihypertensives users (2.76 % ) was higher than that in nonusers of antihypertensives (1.51% ). While the increase had no satistically significant after controlling the confounding factors. With adjustment for a wide range of potential confounding factors, hypoglycaemia was significantly associated with current use of compound antihypertensive tablets and other antihypertensives in combination medications among the elderly hypertensive diabetic patients using sulphonylureas compared with antihypertensive nonusers (RR, 6.87; 95% confidence interral(CI), 1.01 -47.21). Using the above group as the refevence, other classes of antihypertensive including cardioselective β-Blockers, diuretics, Zhenju antihypertensive tablets, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors had no higher risks of hypoglycemia( P ＞ 0.05), while among them ACE inhibitors in single medication would be cautious because of its highest incidence of hypoglycemia(4.91 % ). CONCLUSION Some traditional compound preparations like compound antihypertensive tablets could increase the risk of hypoglycemia among elderly hypertensive diabetic patients using sulphonylureas. Selection of antihypertensive agents should be judicious, based on not only the effectiveness but also the impact on metabolic control for elderly diabetic patients.
关键词
老年糖尿病合并高血压/抗糖尿病药物/抗高血压药物/队列研究/Poisson回归Key words
elderly hypertensive diabetic patient/antidiabetic drug/antihypertensive drug/cohort study/Poisson regression分类
医药卫生引用本文复制引用
汤文璐,王永铭,杜文民,程能能,陈斌艳..老年糖尿病人群低血糖风险和抗高血压药物应用的队列研究[J].中国临床药学杂志,2005,14(4):214-219,6.
