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Article: Meta-analysis of large outcome trials of angiotensin receptor blockers in hypertension
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TitleMeta-analysis of large outcome trials of angiotensin receptor blockers in hypertension
 
AuthorsCheung, BMY1
Cheung, GTY1
Lauder, IJ1
Lau, CP1
Kumana, CR1
 
KeywordsChemicals And Cas Registry Numbers
 
Issue Date2006
 
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhh
 
CitationJournal Of Human Hypertension, 2006, v. 20 n. 1, p. 37-43 [How to Cite?]
DOI: http://dx.doi.org/10.1038/sj.jhh.1001931
 
AbstractAngiotensin receptor blockers (ARBs), also known as sartans, block the activation of angiotensin type 1 receptors and have a recognised role in the treatment of heart failure and nephropathy. Since 2002, there have been three major outcome trials of ARBs in hypertension. We performed a meta-analysis to evaluate the impact of ARB on major outcomes. Randomised controlled trials of ARBs in hypertensive subjects with an average follow-up of at least 2 years and at least 100 major cardiovascular events were included. For each trial, the ARB used, number and characteristics of subjects, baseline and change in blood pressure, cardiovascular and noncardiovascular outcomes were recorded. Three trials involving 29375 subjects were included in the meta-analysis. In Losartan Intervention For Endpoint (LIFE) and Study on Cognition and Prognosis in the Elderly (SCOPE) but not in Valsartan Antihypertensive Long-term Use Evaluation trial (VALUE), an ARB reduced the occurrence of the primary end point and stroke compared to control. Compared to other antihypertensive drugs, ARB treatment was associated with no significant change in all-cause mortality (relative risk ratio (RRR) 0.96, 95% CI: 0.88-1.06, P = 0.45). There was an increase in myocardial infarction (RRR, 1.12, 95% CI: 1.01-1.26, P = 0.041), but a decrease in new-onset diabetes mellitus (RRR, 0.80, 95% CI: 0.74-0.86, P < 0.0000001). In conclusion, the reduction in new-onset diabetes partly offsets any increase in the risk of myocardial infarction. Most hypertensive patients require more than one class of drugs. Small differences in treatment outcome should not over-ride the importance of good blood pressure control. © 2006 Nature Publishing Group. All rights reserved.
 
ISSN0950-9240
2012 Impact Factor: 2.818
2012 SCImago Journal Rankings: 0.898
 
DOIhttp://dx.doi.org/10.1038/sj.jhh.1001931
 
ISI Accession Number IDWOS:000233971400006
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheung, BMY
 
dc.contributor.authorCheung, GTY
 
dc.contributor.authorLauder, IJ
 
dc.contributor.authorLau, CP
 
dc.contributor.authorKumana, CR
 
dc.date.accessioned2010-09-17T10:20:11Z
 
dc.date.available2010-09-17T10:20:11Z
 
dc.date.issued2006
 
dc.description.abstractAngiotensin receptor blockers (ARBs), also known as sartans, block the activation of angiotensin type 1 receptors and have a recognised role in the treatment of heart failure and nephropathy. Since 2002, there have been three major outcome trials of ARBs in hypertension. We performed a meta-analysis to evaluate the impact of ARB on major outcomes. Randomised controlled trials of ARBs in hypertensive subjects with an average follow-up of at least 2 years and at least 100 major cardiovascular events were included. For each trial, the ARB used, number and characteristics of subjects, baseline and change in blood pressure, cardiovascular and noncardiovascular outcomes were recorded. Three trials involving 29375 subjects were included in the meta-analysis. In Losartan Intervention For Endpoint (LIFE) and Study on Cognition and Prognosis in the Elderly (SCOPE) but not in Valsartan Antihypertensive Long-term Use Evaluation trial (VALUE), an ARB reduced the occurrence of the primary end point and stroke compared to control. Compared to other antihypertensive drugs, ARB treatment was associated with no significant change in all-cause mortality (relative risk ratio (RRR) 0.96, 95% CI: 0.88-1.06, P = 0.45). There was an increase in myocardial infarction (RRR, 1.12, 95% CI: 1.01-1.26, P = 0.041), but a decrease in new-onset diabetes mellitus (RRR, 0.80, 95% CI: 0.74-0.86, P < 0.0000001). In conclusion, the reduction in new-onset diabetes partly offsets any increase in the risk of myocardial infarction. Most hypertensive patients require more than one class of drugs. Small differences in treatment outcome should not over-ride the importance of good blood pressure control. © 2006 Nature Publishing Group. All rights reserved.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationJournal Of Human Hypertension, 2006, v. 20 n. 1, p. 37-43 [How to Cite?]
DOI: http://dx.doi.org/10.1038/sj.jhh.1001931
 
dc.identifier.citeulike304053
 
dc.identifier.doihttp://dx.doi.org/10.1038/sj.jhh.1001931
 
dc.identifier.eissn1476-5527
 
dc.identifier.epage43
 
dc.identifier.isiWOS:000233971400006
 
dc.identifier.issn0950-9240
2012 Impact Factor: 2.818
2012 SCImago Journal Rankings: 0.898
 
dc.identifier.issue1
 
dc.identifier.pmid16121197
 
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dc.identifier.spage37
 
dc.identifier.urihttp://hdl.handle.net/10722/91486
 
dc.identifier.volume20
 
dc.languageeng
 
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhh
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofJournal of Human Hypertension
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 and over
 
dc.subject.meshAngiotensin II Type 1 Receptor Blockers - therapeutic use
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshHypertension - drug therapy
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshRandomized Controlled Trials as Topic
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshTreatment Outcome
 
dc.subjectChemicals And Cas Registry Numbers
 
dc.titleMeta-analysis of large outcome trials of angiotensin receptor blockers in hypertension
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong