Angiotensin II receptor blockers for the treatment of portal hypertension in patients with liver cirrhosis: a systematic review and meta-analysis of randomized controlled trials

Irish Journal of Medical Science
Huijing Yao, Chunqing Zhang

Abstract

Randomized controlled trials (RCTs) showed inconsistent results regarding the efficacy of angiotensin II receptor blockers (ARBs) on portal pressure as indicated by hepatic venous pressure gradient (HVPG). A meta-analysis of RCTs was performed to evaluate the influence of ARBs treatment on HVPG. PubMed, Embase, and Cochrane's Library were searched for relevant RCTs. A fixed or a randomized effect model was used to pool the results according the heterogeneity. Subgroup analyses were performed to explore the source of heterogeneity. Eleven RCTs with 394 patients were included. ARBs treatment did not significantly change HVPG as compared with controls (weighted mean difference [WMD] = -0.63, 95% confidence interval [CI] -1.73 to 0.47 mmHg, p = 0.26; I2 = 60%). These results were consistent in studies comparing ARBs with propranolol (WMD = -0.40, 95% CI -2.22 to 1.41 mmHg, p = 0.67; I2 = 68%), and those comparing ARBs with non-active controls including placebo or no treatment (WMD = -1.05, 95% CI -2.33 to 0.24 mmHg, p = 0.13; I2 = 44%). These results were also not affected by the individual ARBs used. Moreover, treatment of ARBs significantly reduced mean arterial blood pressure (WMD = -6.12, 95% CI -9.69 to -2.55 mmHg, p = 0.008; ...Continue Reading

References

Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Jan 27, 1999·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·A W SchneiderC P Klein
Jul 12, 2002·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Jun 24, 2003·The American Journal of Gastroenterology·Binay K DeSanjay Dasgupta
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Apr 22, 2008·The American Journal of Gastroenterology·Michael SchepkeTilman Sauerbruch
Apr 17, 2009·The Cochrane Database of Systematic Reviews·Jill FerrariTrevor D Prior
Jul 23, 2009·BMJ : British Medical Journal·David MoherUNKNOWN PRISMA Group
Mar 5, 2010·The New England Journal of Medicine·Guadalupe Garcia-Tsao, Jaime Bosch
Jul 13, 2011·Liver International : Official Journal of the International Association for the Study of the Liver·Yasuko Iwakiri
Oct 19, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Dhiraj Tripathi, Peter C Hayes
Feb 1, 2014·Lancet·Emmanuel A TsochatzisAndrew K Burroughs
Apr 1, 2014·Clinics in Liver Disease·Annalisa Berzigotti, Jaime Bosch
Apr 8, 2015·World Journal of Hepatology·Balasubramaniyan Vairappan
Oct 9, 2016·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Mattias Mandorfer, Thomas Reiberger
Jan 19, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Càndid VillanuevaCarlos Guarner
May 24, 2017·Gastroenterology Report·Bogdan Procopet, Annalisa Berzigotti

❮ Previous
Next ❯

Citations

Feb 27, 2019·Journal of Veterinary Internal Medicine·Marisa K AmesBertram Pitt
Dec 20, 2018·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Maya FujiiYukio Yuzawa
Oct 4, 2019·Liver International : Official Journal of the International Association for the Study of the Liver·Giovanni SansoèFlorence Wong

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.