Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis.

@article{Psaty2003HealthOA,
  title={Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis.},
  author={Bruce M. Psaty and Thomas Lumley and Curt D. Furberg and Gina D. Schellenbaum and Marco Pahor and Michael H. Alderman and Noel S Weiss},
  journal={JAMA},
  year={2003},
  volume={289 19},
  pages={
          2534-44
        }
}
CONTEXT Establishing relative benefit or harm from specific antihypertensive agents is limited by the complex array of studies that compare treatments. Network meta-analysis combines direct and indirect evidence to better define risk or benefit. OBJECTIVE To summarize the available clinical trial evidence concerning the safety and efficacy of various antihypertensive therapies used as first-line agents and evaluated in terms of major cardiovascular disease end points and all-cause mortality… 

Figures and Tables from this paper

Comparative effectiveness of antihypertensive medication for primary prevention of cardiovascular disease: systematic review and multiple treatments meta-analysis
TLDR
Based on the available evidence, there seems to be little or no difference between commonly used blood pressure lowering medications for primary prevention of cardiovascular disease.
Re-examining the efficacy of β-blockers for the treatment of hypertension: a meta-analysis
TLDR
β-blockers should not be considered first-line therapy for older hypertensive patients without another indication for these agents; however, in younger patients β-blocker are associated with a significant reduction in cardiovascular morbidity and mortality.
Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis
TLDR
The findings support the use of ACE inhibitors as the first line antihypertensive agent in patients with diabetes and calcium channel blockers might be the preferred treatment in combination with ACE inhibitors if adequate blood pressure control cannot be achieved by ACE inhibitors alone.
Pharmacotherapy for mild hypertension.
TLDR
Antihypertensive drugs used in the treatment of adults (primary prevention) with mild hypertension have not been shown to reduce mortality or morbidity in RCTs.
Network meta-analysis of antiplatelet treatments for secondary stroke prevention.
Network meta-analysis is a fairly new method for assessing the relative effectiveness of two treatments when they have not been directly evaluated in a controlled randomized trial (CRT) but have each
Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis
TLDR
Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms, and Naproxen seemed least harmful.
Long-Term Anti-Hypertensive Therapy and Stroke Prevention: A Meta-Analysis
TLDR
Among the antihypertensive classes, CCBs were most effective in reducing the long-term incidence of stroke, whereas β-blockers were associated with significantly increased risk.
Network meta-analyses in hypertension.
TLDR
Meta-analyses of antihypertensive drug treatment based on a huge number of trials, patients and outcomes provide an answer to several previously poorly addressed questions, and helping hypertension guidelines to extend evidence-based recommendations.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 108 REFERENCES
Meta-analysis of Trials Comparing β-Blockers, Calcium Antagonists, and Nitrates for Stable Angina
TLDR
β-Blockers provide similar clinical outcomes and are associated with fewer adverse events than calcium antagonists in randomized trials of patients who have stable angina in a comparison of relative efficacy and tolerability in antianginal drugs.
Overview of Randomized Trials of Angiotensin-Converting Enzyme Inhibitors on Mortality and Morbidity in Patients With Heart Failure
TLDR
Total mortality and hospitalization for congestive heart failure are significantly reduced by ACE inhibitors with consistent effects in a broad range of patients.
Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials.
TLDR
Reductions for total mortality and the combined endpoint were similar for various subgroups examined, but patients with the lowest ejection fraction appeared to have the greatest benefit.
Hypertension in the elderly. Implications and generalizability of randomized trials.
TLDR
Randomized trials demonstrate that treating healthy older persons with hypertension is highly efficacious, and five-year morbidity and mortality benefits derived from trials are greater for older than younger subjects.
Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes.
TLDR
Compared with the alternative agents tested, ACE inhibitors may provide a special advantage in addition to blood pressure control and the question of whether atenolol is equivalent to captopril remains open.
Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). ALLHAT Collaborative Research Group.
TLDR
The data indicate that compared with doxazosin, chlorthalidone reduces the risk of combined CVD events, particularly CHD death/nonfatal MI, in high-risk hypertensive patients.
...
1
2
3
4
5
...