列宁抑制剂与血管激素受体阻断剂对初级高血压的治疗
Gan Mi Wang1, Liang Jin Li1, Linyi Fan2
1Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai, China.
The Cochrane database of systematic reviews
|February 27, 2025
概括
列宁抑制剂和血管激素受体抑制剂 (ARBs) 对高血压表现出类似的有效性,死亡率或不良事件没有显著差异. 需要进一步的研究来确定长期的益处和危害.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 高血压管理 高血压管理
背景情况:
- 宁抑制剂阻断了宁-血管新生素系统 (RAS) 的速度限制步骤.
- 之前的研究表明,宁抑制剂具有良好的耐受性和类似于ARBs的降血压效果.
- 雷宁抑制剂与ARBs对高血压的比较益处和危害尚未得到充分证实.
研究的目的:
- 在患有初级高血压的患者中,与ARB相比,评估宁抑制剂的益处和危害.
- 综合来自随机对照试验 (RCT) 的证据,以比较有效性和安全性.
主要方法:
- 对RCT进行了对多个数据库 (Cochrane高血压,MEDLINE,Embase) 的系统搜索.
- 包括双盲并行设计试验,比较初级高血压中的宁抑制剂和ARBs.
- 主要结局包括死亡率,心血管事件,病和不良事件;次要结局评估了特定的疾病和血压.
主要成果:
- 包括11个RCT,其中6780名参与者患有轻度初级高血压;随访范围从4周到9个月.
- 对于所有原因的死亡率 (低确定性证据),由于不良反应而导致的戒断 (中度确定性),严重不良事件 (中度确定性) 或总体不良事件 (中度确定性) 之间没有发现显著差异.
- 降低血压是相似的,在静缩 (中度确定性) 和静缩 (低确定性) 血压的差异很小.
结论:
- 目前的证据表明,在轻度初级高血压的死亡率,安全性或血压控制方面,宁抑制剂和ARB之间几乎没有差异.
- 现有的证据受到短暂的试验持续时间和低发病率结果的发生限制.
- 需要更大,更长期的以心血管结果为重点的RCT来充分阐明比较有效性和安全性.
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