Abstract | BACKGROUND AND OBJECTIVES: We have recently published an overview and meta-analysis of the effects of the five major classes of blood pressure-lowering drugs on cardiovascular outcomes when compared with placebo. However, possible differences in effectiveness of the various classes can correctly be estimated only by head-to-head comparisons of different classes of agents. This has been the objective of a new survey and meta-analysis. METHODS: A database search between 1966 and August 2014 ide ntified 50 eligible randomized controlled trials for 58 two-drug comparisons (247 006 patients for 1 029 768 patient-years). Risk ratios and their 95% confidence intervals of seven outcomes were estimated by a random-effects model. RESULTS: CONCLUSIONS: The results of all available evidence from head-to-head drug class comparisons do not allow the formulation of a fixed paradigm of drug choice valuable for all hypertensive patients, but the differences found may suggest specific choices in specific conditions, or preferable combinations of drugs.
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Authors | Costas Thomopoulos, Gianfranco Parati, Alberto Zanchetti |
Journal | Journal of hypertension
(J Hypertens)
Vol. 33
Issue 7
Pg. 1321-41
(Jul 2015)
ISSN: 1473-5598 [Electronic] Netherlands |
PMID | 26039526
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Adrenergic beta-Antagonists
- Angiotensin Receptor Antagonists
- Angiotensin-Converting Enzyme Inhibitors
- Antihypertensive Agents
- Calcium Channel Blockers
- Diuretics
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Topics |
- Adrenergic beta-Antagonists
(therapeutic use)
- Angiotensin Receptor Antagonists
(therapeutic use)
- Angiotensin-Converting Enzyme Inhibitors
(therapeutic use)
- Antihypertensive Agents
(therapeutic use)
- Blood Pressure
(drug effects)
- Calcium Channel Blockers
(therapeutic use)
- Cardiovascular Diseases
(drug therapy)
- Cause of Death
- Coronary Artery Disease
(epidemiology)
- Diuretics
(therapeutic use)
- Heart Failure
(epidemiology)
- Humans
- Hypertension
(drug therapy, mortality, physiopathology)
- Incidence
- Renin-Angiotensin System
(drug effects)
- Risk Factors
- Treatment Outcome
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