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Impact of Antihypertensive Agents on Central Systolic Blood Pressure and Augmentation Index: A Meta-Analysis

McGaughey, Tracey J., Fletcher, Emily A., Shah, Sachin A.·2016·American Journal of Hypertension
DOI 10.1093/ajh/hpv134
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Abstract

BACKGROUND: New evidence suggests that central systolic blood pressure (cSBP) and augmentation index (AI) are superior predictors of adverse cardiovascular outcomes compared to peripheral systolic BP (pSBP). We performed a meta-analysis assessing the impact of antihypertensives on cSBP and AI. METHODS: PubMed, Cochrane Library, and CINAHL were searched until September 2014 to identify eligible articles. A DerSimonian and Laird random-effects model was used to calculate the weighted mean difference (WMD) and its 95% confidence interval (CI). Fifty-two and 58 studies incorporating 4,381 and 3,716 unique subjects were included for cSBP and AI analysis, respectively. RESULTS: Overall, antihypertensives reduced pSBP more than cSBP (WMD 2.52mm Hg, 95% CI 1.35 to 3.69; I2 = 21.9%). β-Blockers (BBs) posed a significantly greater reduction in pSBP as compared to cSBP (WMD 5.19mm Hg, 95% CI 3.21 to 7.18). α-Blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, renin-angiotensin aldosterone system inhibitors and nicorandil reduced cSBP and pSBP in a similar manner. The overall reduction in AI from baseline was 3.09% (95% CI 2.28 to 3.90; I2 = 84.5%). A significant reduction in AI was seen with angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, renin-angiotensin aldosterone system inhibitors, BBs, α-blockers (ABs), nicorandil, and moxonidine reduced AI nonsignificantly. CONCLUSIONS: BBs are not as beneficial as the other antihypertensives in reducing cSBP and AI.

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Metadata

Authors
McGaughey, T. J., Fletcher, E. A., & Shah, S. A.
Affiliations
Department of Pharmacy, David Grant Medical Center, Travis Air Force Base Fairfield, California, USA 1 ;
Venue
American Journal of Hypertension
Publisher
Oxford University Press (OUP)
Published
2015-08-19
Volume
29
Issue
4
Pages
448-457
ISSN
  • 1941-7225
  • 0895-7061
DOI
10.1093/ajh/hpv134
Cited by
40
References
2
Language
en
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)

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