Abstract:
BACKGROUND AND OBJECTIVES:In 68 randomized controlled trials (RCTs), blood pressure (BP) lowering was obtained by using drugs of different classes. We have investigated whether BP lowering by any of the major drug classes is effective in reducing the cardiovascular outcomes. METHODS:A total of 55 RCTs (19,5 267 individuals) were suitable for drug-class meta-analyses. Risk ratios and their 95% confidence intervals of seven fatal and nonfatal outcomes were estimated by a random-effects model. RESULTS:Twelve RCTs (48, 898 patients) compared a diuretic with no treatment. SBP/DBP differences of about -12/-5 mmHg were accompanied by significant reductions of all outcomes, including mortality. The same results were obtained by limiting analyses to eight RCTs using low-dose diuretics. Separate analyses for thiazides, chlorthalidone and indapamide (all low dose) showed each subclass was associated with significant reduction of some major outcome. Five RCTs (18 ,724 patients; SBP/DBP difference -10.5/-7 mmHg) showed beta-blockers significantly reduced stroke, heart failure and major cardiovascular events. In RCTs comparing calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) with placebo smaller SBP/DBP differences were achieved, mostly because in the majority of these later RCTs the antihypertensive drug and placebo were added on a background treatment with other antihypertensive agents. Nonetheless, significant reductions of stroke, major cardiovascular events, cardiovascular and all-cause death were obtained with calcium antagonists (10 RCTs, 30, 359 patients); stroke, coronary heart disease, heart failure and major cardiovascular events by ACE inhibitors (12 RCTs, 35, 707 patients); and stroke, heart failure and major cardiovascular events by ARBs (13 RCTs, 65, 256 patients). CONCLUSION:BP lowering by all classes of antihypertensive drugs is accompanied by significant reductions of stroke and major cardiovascular events. This supports the concept that reduction of these events is because of BP lowering per se rather than specific drug properties. However, evidence of risk reduction of other events and particularly mortality was obtained so far with some drug classes only. As a result of marked differences in the trial design, total cardiovascular risk, SBP/DBP differences and statistical power, comparisons of meta-analyses of different drug-specific placebo-controlled RCTs appear unwarranted.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Thomopoulos C,Parati G,Zanchetti Adoi
10.1097/HJH.0000000000000447subject
Has Abstractpub_date
2015-02-01 00:00:00pages
195-211issue
2eissn
0263-6352issn
1473-5598journal_volume
33pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:Age, hypertension, diabetes mellitus and a history of cardiovascular disease are the most important factors related to the presence of cerebral white matter lesions (WML), which are a common finding in elderly people. This study investigates which factors related to hypertension per se are associated with the...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200203000-00028
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To estimate the sensitivity and specificity of self-reported hypertension (HTN) as compared with the clinical diagnosis in epidemiological studies. METHODS:We searched MEDLINE, Embase, Scopus, Web of Science, LILACS, Google Scholar, and ProQuest Dissertations & Theses Global: Health & Medicine databases. In ...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1097/HJH.0000000000001648
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:A cardiac angiotensin II-generating system has been suspected to be involved in various cardiac pathological conditions. Both angiotensin converting enzyme and human chymase can convert angiotensin I to angiotensin II. OBJECTIVE:To clarify the relative contributions of these two enzymatic pathways to angiot...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715090-00003
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Essential hypertension is characterized by an impairment of endothelium-dependent vasodilatation. OBJECTIVE:To test whether antihypertensive treatment with the angiotensin converting enzyme inhibitor lisinopril can improve vasodilatation in response to endothelium-dependent agonists in essential hypertensiv...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816040-00006
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:The urinary isoflavonoid equol inhibits membrane Na-K-Cl cotransporters at similar concentrations to those at which furosemide inhibits them, but the significance of this action is not known. OBJECTIVE:To investigate the potential salidiuretic and vascular actions of equol in the rat. METHODS:Renal functio...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715110-00015
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:Genetically hypertensive rats provide an excellent model to investigate the genetic mechanisms of hypertension. We previously identified three differentially expressed genes, Acadsb (short/branched chain acyl-CoA dehydrogenase), Comt (catecholamine-O-methyltransferase), and Pnpo (pyridoxine 5'-phosphate oxid...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280103a40
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:Human adrenomedullin precursor is converted to glycine-extended adrenomedullin (AM-Gly), an intermediate inactive form of adrenomedullin. Subsequently, AM-Gly is converted to active form of mature adrenomedullin (AM-m). The aim of the present study was to investigate (i) whether sex or age influences plasma ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200104000-00014
更新日期:2001-04-01 00:00:00
abstract:AIM:To examine the effect of renal denervation (RDN) on blood pressure (BP) and health-related quality of life (QoL) in patients with resistant hypertension, pseudoresistant hypertension due to a white-coat effect and in patients with uncontrolled masked hypertension. METHODS:Using the Medical Outcomes Study 36-Item S...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000698
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Studies were undertaken to clarify the pathophysiologic significance of endogenous endothelin in the control of blood pressure and renal hemodynamics in spontaneously hypertensive rats (SHR). DESIGN:The technique of passive immunization was used to neutralize endogenous endothelin in order to estimate the co...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:Arterial stiffness is an independent cardiovascular risk factor. Aging, high blood pressure and increased renin-angiotensin system activity contribute to increased arterial stiffness in patients with atherosclerotic renovascular hypertension (aRVH). A literature search failed to identify any study related to ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000324
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:In sub-Saharan Africa, cardiovascular disease is becoming a leading cause of death, with high blood pressure as number one risk factor. In Nigeria, access and adherence to hypertension care are poor. A pharmacy-based hypertension care model with remote monitoring by cardiologists through mHealth was piloted ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001877
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Bradykinin is a potent cardioprotective hormone, the beneficial role of which in vivo appears to be limited by its rapid metabolism. Inhibitors of peptidases that degrade endogenously formed bradykinin are themselves cardioprotective, presumably by increasing local bradykinin concentrations. As bradykinin-de...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200107000-00015
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:International recommendations have classified brachial blood pressure (BP) in subgroups enabling better cardiovascular risk stratification. Central BP is an independent predictor of cardiovascular risk, differing from brachial BP through the predominant influence of arterial stiffness and wave reflections. C...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f16a9c
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:We examined the effects of a calcium antagonist and an angiotensin converting enzyme (ACE) inhibitor on contractile and non-contractile protein metabolism and cardiac function in a monocrotaline-induced right ventricular hypertrophy model, in order to define the effects of these drugs on cardiac hypertrophy. ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:DESIGN:Because of uncertainties regarding the complete antihypertensive mechanism of action of beta-adrenoceptor antagonists, the present study determined whether vagal afferent neurons of humans and rats possess beta-adrenoceptors. Such a location would provide an appropriate target for beta-blockers to modulate neuro...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199506000-00009
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:Reflection of the finger pulse wave form is a valid measure of arterial stiffness, which may be continuously assessed during sleep. We investigated the relationships between sleep, sleep-disordered breathing, hypertension, and pulse propagation time (PPT) in patients with suspected sleep apnea. METHODS:The ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001111
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To carry out a population-based evaluation of withdrawal of treatment in primary care using repeated ambulatory blood pressure monitoring (ABPM) assessment to avoid subjecting patients to prolonged periods of excess risk. METHOD:Patients from two community practices (total population 11 034 patients) being a...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715120-00021
更新日期:1997-12-01 00:00:00
abstract::A previously described Pst I restriction fragment length polymorphism in Dahl rats at the Na+, K(+)-adenosine 5'-triphosphatase (ATPase) alpha 1 isoform locus was tested for cosegregation with blood pressure in segregating populations. Inbred Dahl salt-sensitive (S) and inbred Dahl salt-resistant (R) rats were crossed...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199005000-00010
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To determine the role of current weight in mediating the relationship between birth weight and blood pressure within the context of the 'fetal origins' hypothesis. DESIGN:Prospective cohort study of 2507 pregnant women and their singleton offspring, delivered live at term, in Perth, Western Australia between...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-200018080-00003
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Renal infarction can cause abrupt and severe hypertension and less frequently renal failure. Renal infarction results from disruption of renal blood flow in the main ipsilateral renal artery or in a segmental branch. Underlying mechanism is either general, 'embolic' or 'thrombophilic', or local related to pr...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001588
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to assess the prognostic value of changes in left ventricular hypertrophy in hypertensive patients with time. DESIGN:Two hundred and fifteen uncomplicated hypertensive patients underwent a high-quality baseline echocardiogram for left ventricular anatomy evaluation and in 151...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199510000-00003
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To investigate the association between hypertension and musculoskeletal complaints among men and women selected by a population-based sample. METHODS:A cross-sectional study, with participants selected using a multistage sampling procedure and interviewed at home, was conducted to investigate the association...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283588268
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To conduct a longitudinal evaluation of the central haemodynamic adaptations of normal pregnancy. METHODS:This was a prospective longitudinal study involving healthy, normotensive women who were having an uncomplicated, singleton pregnancy. Brachial and central SBP, DBP, mean arterial pressure (MAP), brachia...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001768
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:The value of SBP during exercise and recovery period as a risk marker for sudden cardiac death (SCD) is not known. Thus, we assessed the association of SBP during recovery from exercise testing with the risk of SCD. METHODS:SBP was measured every 2 min during and at 2 min after a progressive cycle ergometer ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000066
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:We aim to synthesize effects of repeated administration (≥3 days) of inorganic nitrate on blood pressure and arterial stiffness measures. METHODS:We conducted a systematic review and meta-analysis of randomized controlled trials with at least 3 days treatment of inorganic nitrate on blood pressure and arteri...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002524
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Familial hyperkalaemic hypertension (FHH) is a Mendelian form of low-renin hypertension characterized by hyperkalaemia and hyperchloraemic acidosis despite a normal glomerular filtration rate. To date, three different loci have been identified, on chromosomes 1, 17 and 12. OBJECTIVE:To test for genetic link...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200111000-00005
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:It has been suggested that non-invasive aortic stiffness measurements can be used as an indicator of atherosclerosis. The relationships of arterial stiffness with arterial wall hypertrophy and atherosclerosis however, have rarely been investigated in large-scale studies. The present study reports the associat...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200201000-00013
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:The interactions between eNOS or oxidative stress and bradykinin under long-term treatment of angiotensin II type 1 receptor antagonists (ATRA) remain unknown. To elucidate the molecular mechanisms of the cardioprotective effect of ATRA, we evaluated whether valsartan affects the bradykinin-eNOS and nicotina...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32814db89f
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:Orthostatic hypotension is a common condition associated with adverse cardiovascular and cognitive prognosis. Screening for orthostatic hypotension consists of blood pressure measurements in supine (or sitting) and standing position during clinical consultations. As orthostatic hypotension is a poorly reprodu...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001986
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:Hypertension in midlife adults is associated with cognitive decline later in life. In individuals treated for hypertension, blood pressure (BP) loads have been associated with end organ damages. This study examines whether BP load inversely correlates with performance in cognitive tasks in normotensive or ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002155
更新日期:2019-11-01 00:00:00