Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis

doi:10.1097/HJH.0000000000001720

	Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis
	Xie, Wuxiang 1,2; Zheng, Fanfan3,4 ; Evangelou, Evangelos 2; Liu, Ou 5; Yang, Zhenchun 2; Chan, Queenie 2; Elliott, Paul 2; Wu, Yangfeng 1
刊名	JOURNAL OF HYPERTENSION
	2018-06-01
卷号	36 期号:6 页码:1256-1265
关键词	Blood Pressure-lowering Cardiovascular Disease Meta-analysis Secondary Prevention
DOI	10.1097/HJH.0000000000001720
文献子类	Review
英文摘要	Objective: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.
WOS关键词	CORONARY-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
WOS研究方向	Cardiovascular System & Cardiology
语种	英语
WOS记录号	WOS:000431515500005
资助机构	Newton International Fellowship from the Academy of Medical Sciences(P56804)
内容类型	期刊论文
源URL	[http://ir.ia.ac.cn/handle/173211/22035]
专题	自动化研究所_脑网络组研究中心
作者单位	1.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
推荐引用方式 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.