TY - JOUR
T1 - The effects of aldosterone antagonists in patients with resistant hypertension
T2 - A meta-analysis of randomized and nonrandomized studies
AU - Dahal, Khagendra
AU - Kunwar, Sumit
AU - Rijal, Jharendra
AU - Alqatahni, Fahad
AU - Panta, Raju
AU - Ishak, Noshi
AU - Russell, Roy Patterson
N1 - Publisher Copyright:
© American Journal of Hypertension, Ltd 2015.
PY - 2015/8/5
Y1 - 2015/8/5
N2 - BACKGROUND A few studies have shown aldosterone antagonists (AA) to be effective therapy in patients with resistant hypertension (RH). We performed a meta-analysis of randomized and nonrandomized studies of AA in patients with RH. METHODS We searched PUBMED, EMBASE, and CENTRAL for studies on the use of AA in patients with RH. Meta-analysis was performed using random-effects model. The change in office and ambulatory blood pressures (BP), effects on biochemical profile, change in the number of antihypertensive agents, and adverse events were main outcomes. RESULTS We included 15 studies (3 randomized controlled trials, 1 nonrandomized comparative study, and 11 single-arm studies) with 1,204 total patients in the meta-analysis. In comparative studies, AA reduced systolic BP (SBP) by 24.26mm Hg (95% CI: 8.65-39.87, P = 0.002) and diastolic BP (DBP) by 7.79mm Hg (3.79-11.79, P = 0.0001). Similarly, AA reduced SBP by 22.74mm Hg (18.21-27.27, P < 0.00001) and DBP by 10.49mm Hg (8.85-12.13, P < 0.00001) in single-arm studies. AA resulted in significant change in serum electrolytes in single-arm studies but not in comparative studies. Significantly more adverse events were noted in single-arm studies but not in comparative studies. CONCLUSIONS On the basis of the current meta-analysis, we conclude that AA is safe and effective therapy in patients with RH.
AB - BACKGROUND A few studies have shown aldosterone antagonists (AA) to be effective therapy in patients with resistant hypertension (RH). We performed a meta-analysis of randomized and nonrandomized studies of AA in patients with RH. METHODS We searched PUBMED, EMBASE, and CENTRAL for studies on the use of AA in patients with RH. Meta-analysis was performed using random-effects model. The change in office and ambulatory blood pressures (BP), effects on biochemical profile, change in the number of antihypertensive agents, and adverse events were main outcomes. RESULTS We included 15 studies (3 randomized controlled trials, 1 nonrandomized comparative study, and 11 single-arm studies) with 1,204 total patients in the meta-analysis. In comparative studies, AA reduced systolic BP (SBP) by 24.26mm Hg (95% CI: 8.65-39.87, P = 0.002) and diastolic BP (DBP) by 7.79mm Hg (3.79-11.79, P = 0.0001). Similarly, AA reduced SBP by 22.74mm Hg (18.21-27.27, P < 0.00001) and DBP by 10.49mm Hg (8.85-12.13, P < 0.00001) in single-arm studies. AA resulted in significant change in serum electrolytes in single-arm studies but not in comparative studies. Significantly more adverse events were noted in single-arm studies but not in comparative studies. CONCLUSIONS On the basis of the current meta-analysis, we conclude that AA is safe and effective therapy in patients with RH.
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U2 - 10.1093/ajh/hpv031
DO - 10.1093/ajh/hpv031
M3 - Article
C2 - 25801902
AN - SCOPUS:84931288451
VL - 28
SP - 1376
EP - 1385
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 11
ER -