梅震宇醫生 — 每日一次血壓藥和膽固醇藥 服用時間會影響治療效果?

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經常有病人問我,每日一次的血壓藥和降膽固醇藥(主要是他汀類藥物, statins),應該在什麼時候服用。


最近有大型研究指出,血壓藥無論在早上或晚上服用,對減少心肌梗塞、中風的效果或心血管疾病所引致的死亡率,都沒有明顯分別。經驗上,有些病人在某些時間的血壓會過高或過低,我會建議調節服用時間以達致最佳效果。


至於膽固醇嘅方面,由於人類身體在晚上會製造較多膽固醇,所以有些人建議藥效較短的他汀類藥物(例如,pravastatin, simvastatin, lovastatin, fluvastatin)應在晚上服用,以增加療效,但這並沒有足夠的臨床證據支持。而有一些研究發現,他汀類藥物無論在早上或晚上服用,對血液中膽固醇和三酸甘油脂水平的控制,都沒有明顯分別。


簡言之,兩種藥無論在每天的什麼時候,只要定時服用,都可達致其理想效果。


1. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. I.S. Mackenzie et al. 22 October 2022. The Lancet, vol 400, issue 10361, 1417-1425.
2. Chronotherapy versus conventional statins therapy for the treatment of hyperlipidaemia. J.M. Fernandez-Tabera et al. 26 November 2016. Cochrane Database of Systematic Reviews.
3. The optimal time of day for statin administration: a review of current evidence. K. Awad et al. August 2018. Current Opinion in Lipidology 29(4), 240-245.



資料來源:https://bit.ly/3Xrulc7

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