关于治心衰药物极少有严重副作用的原因,关于治心衰药物极少有严重副作用的相关知识。 NEW YORK (Reuters Health) - A class of blood-pressure lowering drugs known as ACE inhibitors may cause fewer side effects in people with heart failure than doctors think, researchers report.
Heart failure is a condition in which the heart becomes enlarged and pumps blood inefficiently, resulting in fatigue and fluid retention in the limbs and lungs. In severe cases, a heart transplant may be required.
In a study of people with heart failure who took an ACE inhibitor for the first time, less than 2% stopped taking the medication due to severe side effects. The results of the study are published in the November 4th issue of the British Medical Journal.
ACE inhibitors have a good track record for treating heart failure, but the drugs are underprescribed in the UK, according to a team of researchers led by Dr. James Mason, of the University of Birmingham in England.
To see whether fears of the drugs’ side effects are justified, the researchers carried out a two-part study of the ACE inhibitor enalapril. In the first part, more than 7,000 people took the drug for 2 to 7 days. In the second phase, more than 2,500 people with heart failure who were able to take enalapril without experiencing severe side effects were randomly assigned to take the drug or a placebo pill that did not contain any medication for one year.
During the first phase of the study, almost 8% of the participants experienced side effects including low blood pressure, change in taste and rash, according to the report. But only 1.8% of the people in the study stopped taking the medication due to severe side effects. Older people and those with more severe heart failure were more likely to experience serious side effects.
In the second phase of the study, some of the side effects included change in taste, rash, low blood pressure and blood clots in the lungs, but people taking the ACE inhibitor did not have a higher risk of side effects, the authors report. ’’Overall, there was no difference in the rates of side effects leading to dose reduction or withdrawal between the enalapril and placebo groups,’’ according to Mason’s team.
``Doctors’ perceptions of the risks of these drugs in patients with heart failure are exaggerated,’’ Mason and his colleagues conclude.
But concerns about side effects may not be the only reason that ACE inhibitors are underprescribed for people with heart failure, according to an accompanying editorial.
``Lack of resources and expertise, not fear of side effects, are the great barriers to efficient treatment of heart failure,’’ write Dr. John G. F. Cleland, of Castle Hill Hospital, and Drs. Andrew Clark and John L. Caplin, of Hull Royal Infirmary in Kingston upon Hull, UK.
Improving access to a heart test called echocardiography, which is used to confirm a suspected diagnosis of heart failure, might lead to an increase in ACE inhibitor prescriptions, according to the editorialists. They point out that in the UK, the test is usually performed only in hospitals, but in other countries, it is carried out in clinics and doctors’ offices.
SOURCE: British Medical Journal 2000;321:1095-1096, 1113-1116.
Heart failure is a condition in which the heart becomes enlarged and pumps blood inefficiently, resulting in fatigue and fluid retention in the limbs and lungs. In severe cases, a heart transplant may be required.
In a study of people with heart failure who took an ACE inhibitor for the first time, less than 2% stopped taking the medication due to severe side effects. The results of the study are published in the November 4th issue of the British Medical Journal.
ACE inhibitors have a good track record for treating heart failure, but the drugs are underprescribed in the UK, according to a team of researchers led by Dr. James Mason, of the University of Birmingham in England.
To see whether fears of the drugs’ side effects are justified, the researchers carried out a two-part study of the ACE inhibitor enalapril. In the first part, more than 7,000 people took the drug for 2 to 7 days. In the second phase, more than 2,500 people with heart failure who were able to take enalapril without experiencing severe side effects were randomly assigned to take the drug or a placebo pill that did not contain any medication for one year.
During the first phase of the study, almost 8% of the participants experienced side effects including low blood pressure, change in taste and rash, according to the report. But only 1.8% of the people in the study stopped taking the medication due to severe side effects. Older people and those with more severe heart failure were more likely to experience serious side effects.
In the second phase of the study, some of the side effects included change in taste, rash, low blood pressure and blood clots in the lungs, but people taking the ACE inhibitor did not have a higher risk of side effects, the authors report. ’’Overall, there was no difference in the rates of side effects leading to dose reduction or withdrawal between the enalapril and placebo groups,’’ according to Mason’s team.
``Doctors’ perceptions of the risks of these drugs in patients with heart failure are exaggerated,’’ Mason and his colleagues conclude.
But concerns about side effects may not be the only reason that ACE inhibitors are underprescribed for people with heart failure, according to an accompanying editorial.
``Lack of resources and expertise, not fear of side effects, are the great barriers to efficient treatment of heart failure,’’ write Dr. John G. F. Cleland, of Castle Hill Hospital, and Drs. Andrew Clark and John L. Caplin, of Hull Royal Infirmary in Kingston upon Hull, UK.
Improving access to a heart test called echocardiography, which is used to confirm a suspected diagnosis of heart failure, might lead to an increase in ACE inhibitor prescriptions, according to the editorialists. They point out that in the UK, the test is usually performed only in hospitals, but in other countries, it is carried out in clinics and doctors’ offices.
SOURCE: British Medical Journal 2000;321:1095-1096, 1113-1116.