Aliskiren and amlodipine in the management of essential hypertension: meta-analysis of randomized controlled trials.
Aliskiren and amlodipine in the management of essential hypertension: meta-analysis of randomized controlled trials.
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阿利吉仑和氨氯地平治疗原发性高血压：随机对照试验的荟萃分析
DOI：
10.1371/journal.pone.0070111
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zeng C
中科院分区：
文献类型：
--
作者：
Liu Y;Chen K;Kou X;Han Y;Zhou L;Zeng C
研究背景阿利吉仑是一种新型的肾素-血管紧张素-醛固酮系统（RAAS）抑制剂，近年来有报道阿利吉仑与阿利吉仑联合应用控制血压。本分析的主要目的是回顾最近报道的随机对照试验（RCT），以比较单药（阿利吉仑或阿利吉仑单药）和两种药物联合治疗的降压效果和不良事件。方法检索Pubmed、Embase和科克伦对照试验中心数据库。采用Revman v5.0统计程序进行分析。加权平均差（WMD）和95%置信区间（CI）用于计算连续数据，相对风险（RR）和95% CI用于计算二分数据。结果共纳入7个随机对照试验，纳入6074例受试者。我们发现，与阿利吉仑单药治疗（SBP：WMD = −10.42，95%CI −13.03 <$−7.82，P<0.00001; DBP：WMD = −6.60，95%CI −7.22 <$−5.97，P<0.00001）或SBP：WMD = −4.85，95%CI −6.88 <$−2.81，P<0.00001; DBP：WMD = −2.91，95%CI −3.85 <$−1.97，P<0.00001）相比，阿利吉仑/阿利吉仑联合治疗具有更强的降压作用。 联合治疗与单药治疗之间的不良事件无差异，但外周水肿和低钾血症的发生率在联合治疗中显著低于单药治疗（RR = 0.78，0.66 ± 0.92，P = 0.004; RR = 0.51，0.27 ± 0.97，P = 0.04）。 在肥胖（体重指数>= 30 kg/m2）高血压和非肥胖（体重指数<30 kg/m2）高血压患者中发现了相似的降压作用。 此外，两个亚组中联合治疗的血压降低或不良反应无差异。结论阿利吉仑/阿利司他滨联合治疗比单药降压更有效，且不良事件发生率无增加。
Background Aliskiren is a novel renin-angiotensin aldosterone system (RAAS) inhibitor, the combination therapy of aliskiren and amlodipine for blood pressure control have been reported recently. The primary objective of this analysis is to review recently reported randomized controlled trials (RCTs) to compare antihypertensive effects and adverse events between mono (amlodipine or aliskiren alone) and combination therapy of both medicines. Methods Databases for the search included Pubmed, Embase and the Cochrane Central Register of Controlled Trials. Revman v5.0 statistical program was used to analyze the data. Weighted mean differences (WMD) with a 95% confidence interval (CI) were used for the calculation of continuous data, and relative risk (RR) with a 95% CI was used for dichotomous data. Results We analyzed the data from 7 RCTs for a total of 6074 participants in this meta-analysis. We found that the aliskiren/amlodipine combination therapy had a stronger effect in lowering blood pressure as compared with the monotherapy using aliskiren (SBP: WMD = −10.42, 95% CI −13.03∼−7.82, P<0.00001; DBP: WMD = −6.60, 95% CI −7.22∼−5.97, P<0.00001) or amlodipine (SBP: WMD = −4.85, 95% CI −6.88∼−2.81, P<0.00001; DBP: WMD = −2.91, 95% CI −3.85∼−1.97, P<0.00001). No differences were found in terms of adverse events between combination therapy and monotherapy, except for the rates of peripheral edema and hypokalaemia which were significantly lower in the combination therapy than in the amlodipine monotherapy (RR = 0.78, 0.66∼0.92, P = 0.004; RR = 0.51, 0.27∼0.97, P = 0.04). Similar antihypertensive effects were found in both obese (body mass index > = 30 kg/m2) hypertensive and non-obese (body mass index <30 kg/m2) hypertensive patients. Moreover, there was no difference with the blood pressure lowering or adverse effects with regards to the combination therapy in both subgroups. Conclusion We found that aliskiren/amlodipine combination therapy provided a more effective blood pressure reduction than monotherapy with either drug without increase in the occurrence of adverse events.
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影响因子：
8.3
作者：
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