Renoprotective effects of renin-angiotensin system inhibitor combined with calcium channel blocker or diuretic in hypertensive patients: A PRISMA-compliant meta-analysis.

Abstract:

OBJECTIVES:To conduct a meta-analysis of studies comparing the renoprotective effects of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) combined with either calcium channel blocker (CCB) or diuretic, but not both, in hypertensive patients. DATA SOURCES:Pubmed, Embase, Medline, and Cochrane databases were searched to identify randomized controlled trials (RCTs) of blood pressure lowering treatments in patients with hypertension. STUDY SELECTION:RCTs comparing the renoprotective effects of ACEI/ARB plus CCB with ACEI/ARB plus diuretic in hypertensive patients, with at least one of the following reported outcomes: urinary protein, estimated glomerular filtration rate/creatinine clearance (eGFR/CrCl), or serum creatinine. RESULTS:Based on 14 RCTs with 18,125 patients, statistically significant benefits were found in ACEI/ARB plus CCB for maintaining eGFR/CrCl (standardized mean difference [SMD] = 0.36; 95% confidence interval [CI]: 0.20-0.53; P < 0.001), serum creatinine reduction (mean difference [MD] = -0.05 mg/dL; 95% CI: -0.07 to -0.03; P < 0.001). However, no statistical differences were found between the 2 therapeutic strategies in terms of urinary protein (MD = 7.48%; 95% CI: -6.13% to 21.08%; P = 0.28; I = 92%). CONCLUSIONS:This meta-analysis concluded that ACEI/ARB plus CCB have a stronger effect on the maintenance of renal function in patients with hypertension than ACEI/ARB plus diuretic.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Cheng Y,Huang R,Kim S,Zhao Y,Li Y,Fu P

doi

10.1097/MD.0000000000004167

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

e4167

issue

28

eissn

0025-7974

issn

1536-5964

pii

00005792-201607120-00032

journal_volume

95

pub_type

杂志文章,meta分析

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