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Article: Meta-analysis of large outcome trials of angiotensin receptor blockers in hypertension

TitleMeta-analysis of large outcome trials of angiotensin receptor blockers in hypertension
Authors
KeywordsChemicals And Cas Registry Numbers
Issue Date2006
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhh
Citation
Journal Of Human Hypertension, 2006, v. 20 n. 1, p. 37-43 How to Cite?
Abstract
Angiotensin 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.
Persistent Identifierhttp://hdl.handle.net/10722/91486
ISSN
2013 Impact Factor: 2.692
2013 SCImago Journal Rankings: 1.177
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, BMYen_HK
dc.contributor.authorCheung, GTYen_HK
dc.contributor.authorLauder, IJen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorKumana, CRen_HK
dc.date.accessioned2010-09-17T10:20:11Z-
dc.date.available2010-09-17T10:20:11Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Human Hypertension, 2006, v. 20 n. 1, p. 37-43en_HK
dc.identifier.issn0950-9240en_HK
dc.identifier.urihttp://hdl.handle.net/10722/91486-
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.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhhen_HK
dc.relation.ispartofJournal of Human Hypertensionen_HK
dc.subjectChemicals And Cas Registry Numbersen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAngiotensin II Type 1 Receptor Blockers - therapeutic useen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHypertension - drug therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRandomized Controlled Trials as Topicen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleMeta-analysis of large outcome trials of angiotensin receptor blockers in hypertensionen_HK
dc.typeArticleen_HK
dc.identifier.emailCheung, BMY:mycheung@hku.hken_HK
dc.identifier.authorityCheung, BMY=rp01321en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/sj.jhh.1001931en_HK
dc.identifier.pmid16121197en_HK
dc.identifier.scopuseid_2-s2.0-33644939620en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33644939620&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue1en_HK
dc.identifier.spage37en_HK
dc.identifier.epage43en_HK
dc.identifier.eissn1476-5527-
dc.identifier.isiWOS:000233971400006-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheung, BMY=7103294806en_HK
dc.identifier.scopusauthoridCheung, GTY=55108882600en_HK
dc.identifier.scopusauthoridLauder, IJ=35564928000en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridKumana, CR=7005112381en_HK
dc.identifier.citeulike304053-

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