cident patients.Compared with calcium antagonists, β and α–β blockers, angiotensin converting enzyme inhibitors or angiotensin II antagonists, and diuretics may increase the risk of hemodialysis hypotension. Background Antihypertensive medications are often prescribed to manage hypertension in hemodialysis patients, and intradialytic hypotension (IDH) is a common complication in these patients. We investigated the risk of IDH in incident hemodialysis patients who initiated treatment with antihypertensive drugs in monotherapy. Methods The study was conducted as an emulation of a randomized clinical trial in 4072 incident hemodialysis patients who started antihypertensive drug treatment between January 2016 and December 2019. The primary outcome was the occurrence of IDH during hemodialysis sessions. The generalized estimating equation analysis was adjusted by inverse probability treatment weighting. Results Calcium channel blocker (CCB) use was associated with an IDH incidence rate of 7.4 events per person-year (95% confidence interval [CI], 6.2 to 8.6). Compared with CCB use, use of β and α–β blockers was strongly associated with a higher likelihood of IDH (odds ratio [OR] [95% CI, 2.27; 1.50 to 3.43]). The use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (OR [95% CI, 1.71; 1.14 to 2.57]) and diuretics (OR [95% CI, 1.52; 1.07 to 2.16]) were also associated with a higher likelihood of IDH compared with CCB use. Conclusions The study suggests that using β and α–β blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and diuretics may increase the risk of IDH in hemodialysis patients compared with CCB use....

中文翻译：

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抗高血压药物治疗和血内透析低血压的风险


cident 患者。与钙拮抗剂、β 和 α-β 阻滞剂、血管紧张素转换酶抑制剂或血管紧张素 II 拮抗剂以及利尿剂相比，可能会增加血液透析低血压的风险。背景 抗高血压药物通常用于控制血液透析患者的高血压，而透析中低血压 （IDH） 是这些患者的常见并发症。我们调查了在单药治疗中开始使用抗高血压药物治疗的新发血液透析患者发生 IDH 的风险。方法 该研究是在 2016 年 1 月至 2019 年 12 月期间开始抗高血压药物治疗的 4072 名新发血液透析患者中进行的随机临床试验的模拟。主要结局是血液透析期间 IDH 的发生。广义估计方程分析通过逆概率处理加权进行调整。结果 钙通道阻滞剂 （CCB） 的使用与每人每年 7.4 次事件的 IDH 发生率相关 （95% 置信区间 [CI]，6.2 至 8.6）。与使用 CCB 相比，使用 β 和 α-β 阻滞剂与 IDH 的可能性较高密切相关 （比值比 [OR] [95% CI， 2.27;1.50 至 3.43]）。与使用 CCB 相比，使用血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂 （OR [95% CI， 1.71;1.14 至 2.57]）和利尿剂 （OR [95% CI， 1.52;1.07 至 2.16]）也与更高的 IDH 可能性相关。结论 研究表明，与使用 CCB 相比，使用 β 和 α-β 阻滞剂、血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂以及利尿剂可能会增加血液透析患者发生 IDH 的风险。