Angiotensin System Blockade Combined With Calcium Channel Blockers Is Superior to Other Combinations in Cardiovascular Protection With Similar Blood Pressure Reduction: A Meta-Analysis in 20,451 Hypertensive Patients.

The Journal of Clinical Hypertension
Chen ChiYawei Xu

Abstract

The authors aimed to investigate the superiority of angiotensin system blockade (angiotensin-converting enzyme [ACE] inhibitor/angiotensin receptor blocker [ARB]) plus a calcium channel blocker (CCB) (A+C) over other combination therapies in antihypertensive treatment. A meta-analysis in 20,451 hypertensive patients from eight randomized controlled trials was conducted to compare the A+C treatment with other combination therapies in terms of blood pressure (BP) reduction, clinical outcomes, and adverse events. The results showed that BP reduction did not differ significantly among the A+C therapy and other combination therapies in systolic and diastolic BP (P=.87 and P=.56, respectively). However, A+C therapy, compared with other combination therapies, achieved a significantly lower incidence of cardiovascular composite endpoints, including cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke (risk ratio [RR], 0.80; 95% confidence interval [CI], 0.70-0.91; P<.001), but similar all-cause mortality (RR, 0.90; 95% CI, 0.77-1.04; P=.15) and stroke rates (RR, 0.90; 95% CI, 0.77-1.04; P=.09). Moreover, A+C therapy yielded a 4.21 mL/min/1.73 m(2) lower estimated glomerular filtration rate reduction than other ...Continue Reading

References

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Citations

Jun 4, 2016·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Michel E BertrandJean-Jacques Mourad
Jan 7, 2017·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Robert LinsCaroline de Vries
Jul 21, 2021·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·Mohamed SalemHala O El-Mesallamy

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