Abstract | INTRODUCTION: METHODS: MEDLINE, EMBASE, Trip Database, Cochrane Central Register of Controlled Trials, Cochrane Renal Group specialized register, Current Controlled Trials and clinicaltrials.gov were searched for relevant trials. RESULTS: Twenty-nine trials (1581 patients) were included. Overall, mineralocorticoid receptor antagonists lowered both systolic and diastolic blood pressure (-5.24, 95% confidence interval (CI) -8.65, -1.82 mmHg; p=0.003 and -1.96, 95% CI -3.22, -0.69 mmHg; p=0.002 respectively). There were insufficient data to perform a meta-analysis of other cardiovascular effects. However, a systematic review of the studies included suggested a consistent improvement in surrogate markers of cardiovascular disease. Overall, the use of mineralocorticoid receptor antagonists was associated with an increased serum potassium (0.23, 95% CI 0.13, 0.33 mmol/l; p<0.0001) and higher risk ratio (1.76, 95% CI 1.20, 2.57; p=0.001) of hyperkalemia. Data on long-term cardiovascular outcomes and mortality were not available in any of the trials. CONCLUSIONS:
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Authors | Khai P Ng, Julia Arnold, Adnan Sharif, Paramjit Gill, Jonathan N Townend, Charles J Ferro |
Journal | Journal of the renin-angiotensin-aldosterone system : JRAAS
(J Renin Angiotensin Aldosterone Syst)
Vol. 16
Issue 3
Pg. 599-613
(Sep 2015)
ISSN: 1752-8976 [Electronic] England |
PMID | 25784710
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Copyright | © The Author(s) 2015. |
Chemical References |
- Mineralocorticoid Receptor Antagonists
- Creatinine
- Potassium
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Topics |
- Blood Pressure
(drug effects)
- Cardiovascular Diseases
(blood, drug therapy, mortality, physiopathology)
- Carotid Intima-Media Thickness
- Creatinine
(blood)
- Diastole
(drug effects)
- Endothelium, Vascular
(drug effects, physiopathology)
- Glomerular Filtration Rate
- Heart Ventricles
(drug effects, pathology, physiopathology)
- Humans
- Hyperkalemia
(blood, complications)
- Mineralocorticoid Receptor Antagonists
(adverse effects, pharmacology, therapeutic use)
- Organ Size
(drug effects)
- Oxidative Stress
(drug effects)
- Potassium
(blood)
- Publication Bias
- Randomized Controlled Trials as Topic
- Renal Insufficiency, Chronic
(blood, drug therapy, physiopathology)
- Stroke Volume
(drug effects)
- Systole
(drug effects)
- Vascular Stiffness
(drug effects)
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