Blood pressure lowering effects of β-blockers as add-on or combination therapy: A meta-analysis of randomized controlled trials.
Blood pressure lowering effects of β-blockers as add-on or combination therapy: A meta-analysis of randomized controlled trials.
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DOI：
10.1111/jch.14616
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发表时间：
2023-03
期刊：
影响因子：
--
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中科院分区：
文献类型：
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作者进行了一项Meta分析，以评估非阿替洛尔β受体阻滞剂作为单药治疗的辅助治疗或作为联合降压治疗的组成部分在高血压患者中的疗效。作者从PubMed中检索并识别了相关随机对照试验，直至2021年11月。纳入了比较β受体阻滞剂与利尿剂、钙通道阻滞剂（CCB）、血管紧张素转换酶抑制剂（ACEIs）或血管紧张素受体阻滞剂（ARB）降压作用的研究。该分析包括20项研究，5544名参与者。与非β受体阻滞剂单药治疗相比，β受体阻滞剂加用单药治疗可显著降低收缩压和舒张压（加权平均差异（mm Hg）[95%置信区间]分别为：−4.1 [−6.0，−2.2]和−3.7 [−4.6，−2.8]）。这些结果在与利尿剂的比较中一致（收缩压，−10.2 [−14.2，−6.2];舒张压，−5.4 [−8.2，−2.6]），CCB（收缩压，−4.1 [−7.1，−1.0];舒张压，−2.8 [−4.1，−1.5]）和ACEI/ARB（收缩压：-2.9 [-4.3，-1.5];舒张压：-4.2 [-5.0，-3.4]）。联合使用和不联合使用β受体阻滞剂的降压效果无显著差异（收缩压，−1.3 mm Hg [−5.8，3.2];舒张压，−.3 mm Hg [−2.7，2.1]）。与非β受体阻滞剂治疗相比，美托洛尔添加或联合治疗的血压下降幅度显著更大（收缩压，−3.6 mm Hg [−5.9，−1.3];舒张压，−2.1 mm Hg [−3.5，−.7]）。总之，非阿替洛尔β受体阻滞剂作为单药治疗的辅助治疗或作为联合降压治疗的组成部分可有效降低血压。根据目前的高血压指南建议，β受体阻滞剂可以也应该与其他降压药物联合使用。
The authors performed a meta‐analysis to assess the efficacy of non‐atenolol β‐blockers as add‐on to monotherapy or as a component of combination antihypertensive therapy in patients with hypertension. The authors searched and identified relevant randomized controlled trials from PubMed until November 2021. Studies comparing blood pressure lowering effects of β‐blockers with diuretics, calcium channel blockers (CCBs), angiotensin‐converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) were included. The analysis included 20 studies with 5544 participants. β‐blockers add‐on to monotherapy significantly reduced systolic and diastolic blood pressure as compared with non‐β‐blocker monotherapy (weighted mean difference in mm Hg [95% confidence interval]: −4.1 [−6.0, −2.2] and −3.7 [−4.6, −2.8], respectively). These results were consistent across the comparisons with diuretics (systolic pressure, −10.2 [−14.2, −6.2]; diastolic pressure, −5.4 [−8.2, −2.6]), CCBs (systolic pressure, −4.1 [−7.1, −1.0]; diastolic pressure, −2.8 [−4.1, −1.5]), and ACEIs/ARBs (systolic pressure, −2.9 [−4.3, −1.5]; diastolic pressure, −4.2 [−5.0, −3.4]). There was no significant difference in blood pressure lowering effects between combinations with and without a β‐blocker (systolic pressure, −1.3 mm Hg [−5.8, 3.2]; diastolic pressure, −.3 mm Hg [−2.7, 2.1]). Metoprolol add‐on or combination therapy had a significantly greater blood pressure reduction than non‐β‐blocker therapy (systolic pressure, −3.6 mm Hg [−5.9, −1.3]; diastolic pressure, −2.1 mm Hg [−3.5, −.7]). In conclusion, non‐atenolol β‐blockers are effective in lowering blood pressure as add‐on to monotherapy or as a component of combination antihypertensive therapy. In line with the current hypertension guideline recommendations, β‐blockers can and should be used in combination with other antihypertensive drugs.
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DOI：
10.1016/j.jash.2015.03.009
发表时间：
2015-07
期刊：
Journal of the American Society of Hypertension : JASH
影响因子：
--
作者：
Izzo JL Jr;Khan SU;Saleem O;Osmond PJ
通讯作者：
Osmond PJ
影响因子：
2.7
作者：
Andersson, OK
通讯作者：
Andersson, OK
影响因子：
4.9
作者：
Dhakam, Zahid;Yasmin;Wilkinson, Ian B.
通讯作者：
Wilkinson, Ian B.
影响因子：
3.2
作者：
LACOURCIERE, Y;LEFEBVRE, J;ARNOTT, A
通讯作者：
ARNOTT, A
影响因子：
2.9
作者：
LEJEUNE, P;GUNSELMANN, W;SCHREIBER, U
通讯作者：
SCHREIBER, U