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Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis
Xie, Wuxiang1,2; Zheng, Fanfan3,4; Evangelou, Evangelos2; Liu, Ou5; Yang, Zhenchun2; Chan, Queenie2; Elliott, Paul2; Wu, Yangfeng1
Source PublicationJOURNAL OF HYPERTENSION
2018-06-01
Volume36Issue:6Pages:1256-1265
SubtypeReview
AbstractObjective:To systematically evaluate the efficacy of five commonly used blood pressure-lowering drugs in reducing cardiovascular events among patients with nonacute cardiovascular disease, but without heart failure.Methods:We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials on 18 March 2017. The primary outcome was fatal and nonfatal cardiovascular events, and the secondary outcomes were all-cause death, fatal and nonfatal myocardial infarction, and stroke. Pooled risk ratios and corresponding 95% confidence intervals (CIs) were calculated using Mantel-Haenszel random-effects meta-analyses.Results:Twenty-seven randomized controlled trials with 143095 participants and a treatment duration of at least 12 months were included in our analyses. Fifteen trials enrolled patients with coronary artery disease, eight enrolled patients with cerebral artery disease, and four enrolled patients with cardiovascular disease. Of the 27 trials, 10 trials only included hypertensive patients. Compared with placebo, angiotensin-converting enzyme inhibitors (ACEIs) (risk ratio 0.85, 95% CI 0.78-0.92), angiotensin receptor blockers (risk ratio 0.92, 95% CI 0.87-0.98), and diuretics (risk ratio 0.77, 95% CI 0.66-0.90) significantly reduced the risk of cardiovascular events. Apart from this, ACEIs significantly reduced all secondary outcomes, calcium channel blockers, and diuretics reduced stroke significantly. No significant difference was found in head-to-head comparisons of each given drug class with any other class.Conclusions:Although only ACEIs have evidences showing its effect in reducing cardiovascular events and all secondary outcomes, head-to-head comparisons did not provide strong evidence in difference in the effects between these blood pressure-lowering drugs.
KeywordBlood Pressure-lowering Cardiovascular Disease Meta-analysis Secondary Prevention
WOS HeadingsScience & Technology ; Life Sciences & Biomedicine
DOI10.1097/HJH.0000000000001720
WOS KeywordCORONARY-ARTERY-DISEASE ; RANDOMIZED CONTROLLED-TRIAL ; CONVERTING-ENZYME-INHIBITION ; TRANSIENT ISCHEMIC ATTACK ; HIGH-RISK PATIENTS ; ATHEROSCLEROTIC VASCULAR-DISEASE ; ACUTE MYOCARDIAL-INFARCTION ; AMERICAN-HEART-ASSOCIATION ; PLACEBO-CONTROLLED TRIAL ; OUTCOME INCIDENCE
Indexed BySCI
Language英语
Funding OrganizationNewton International Fellowship from the Academy of Medical Sciences(P56804)
WOS Research AreaCardiovascular System & Cardiology
WOS SubjectPeripheral Vascular Disease
WOS IDWOS:000431515500005
Citation statistics
Document Type期刊论文
Identifierhttp://ir.ia.ac.cn/handle/173211/22035
Collection脑网络组研究中心
Affiliation1.Peking Univ, Clin Res Inst, Beijing, Peoples R China
2.Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England
3.Chinese Acad Sci, Inst Automat, Brainnetome Ctr, Beijing, Peoples R China
4.UCL, Inst Cognit Neurosci, London, England
5.Capital Med Univ, Beijing Lab Cardiovasc Precis Med, Anzhen Hosp, Dept Cardiovasc Surg, Beijing, Peoples R China
Recommended Citation
GB/T 7714
Xie, Wuxiang,Zheng, Fanfan,Evangelou, Evangelos,et al. Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis[J]. JOURNAL OF HYPERTENSION,2018,36(6):1256-1265.
APA Xie, Wuxiang.,Zheng, Fanfan.,Evangelou, Evangelos.,Liu, Ou.,Yang, Zhenchun.,...&Wu, Yangfeng.(2018).Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis.JOURNAL OF HYPERTENSION,36(6),1256-1265.
MLA Xie, Wuxiang,et al."Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis".JOURNAL OF HYPERTENSION 36.6(2018):1256-1265.
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