Efficacy and Safety of Levoamlodipine Besylate for Essential Hypertension: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 YI Honggang ¹ , HUANG Gaozhong ² , LIU Guanjian ³

1. Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing 210029, China;2. The Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China3. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

YI Honggang, Email: ohcepf@163.com

Keywords：

Levoamlodipine besylate; Essential hypertension; Efficacy; Safety; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20080125

Video：

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Objective 　To assess the efficacy and safety of levoamlodipine besylate for essential hypertension.
Methods 　We searched MEDLINE (1999 to October 2007), EMBASE (1999 to October 2007), The Cochrane Library (Issue 3, 2007), CNKI (1999 to 2007), Wanfang (1999 to 2007), VIP (1999 to 2007) and CBM (1999 to October 2007). The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration’ s RevMan 4.2 software.
Results 　A total of 345 articles were retrieved, but only 17 were finally included. Meta-analyses showed that the effective rate in patients receiving levoamlodipine besylate was significantly higher than that in patients receiving indapamide (RD 0.14, 95%CI 0.06 to 0.22, P=0.0004), while no significant differences were noted between the levoamlodipine besylate group and other control groups. The incidence of adverse effects was significantly lower in the levoamlodipine besylate group compared to the indapamide group (RD –0.12, 95%CI –0.21 to –0.03, P=0.01), the amlodipine group (RD –0.06, 95%CI –0.11 to –0.01, P=0.02) and the nitrendipine group (RD –0.27, 95%CI –0.46 to – 0.08, P=0.006). No significant differences were observed between the levoamlodipine besylate group and other control groups.
Conclusion 　Levoamlodipine besylate tends to have better efficacy and safety profiles compared with other antihypertensive drugs. However, most trials included in the review were of poor quality and, so, multi-center large-scale randomized controlled trials of higher quality are needed to confirm this.

Citation： YI Honggang,HUANG Gaozhong,LIU Guanjian. Efficacy and Safety of Levoamlodipine Besylate for Essential Hypertension: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(7): 543-550. doi: 10.7507/1672-2531.20080125 Copy

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2.	WHO-ISH Hypertension Guidelines Committee. 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens, 1999, 17: 151-183.
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6.	王文莉, 窦淑良, 张婉荣. 苯磺酸左旋氨氯地平治疗青年人原发性高血压52例疗效及不良反应观察. 陕西医学杂志, 2007, 36(5): 603-605.
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11.	李玉杰. 北京降压0号治疗中青年轻中度高血压的疗效和安全性. 心血管康复医学杂志, 2006, 15(4): 378-380.
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14.	潘正赛. 苯磺酸左旋氨氯地平治疗轻中度高血压的临床观察. 中外健康文摘•医药学刊, 2006, 3(1): 39-39.
15.	何伟珍, 吕干新. 多沙唑嗪与左旋氨氯地平治疗原发性高血压的疗效和安全性. 心脑血管病防治, 2005, 5(3): 48-50.
16.	郑煜, 徐冰. 苯磺酸左旋氨氯地平和硝苯地平治疗轻中度原发性高血压的疗效观察. 实用医技杂志, 2004, 11(9A): 1726-1728.
17.	杨青. 苯磺酸左旋氨氯地平治疗轻、中度高血压临床观察. 宁夏医学杂志, 2004, 26(6): 353-354.
18.	郭冀珍, 钱岳晟, 陶波, 等. 苯磺酸左旋氨氯地平和氯沙坦治疗140例原发性高血压患者的比较. 中国新药与临床杂志, 2003, 22(12): 766-769.
19.	方根强, 陈燕惠, 王一尘, 等. 左旋氨氯地平治疗原发性轻中度高血压病的疗效及安全性评价. 中国综合临床, 2003, 19(10): 897-898.
20.	胡大一, 赵秀丽. 苯磺酸左旋氨氯地平与苯磺酸氨氯地平治疗原发性轻中度高血压的随机、双盲平行研究. 中国医刊, 2002, 37(5): 46-47.
21.	刘国树, 王可. 氨氯地平与左旋氨氯地平治疗夜间高血压疗效比较. 医学研究生学报, 2001, 14(6): 496-498.
22.	Vickers A, Goyal N, Harland R, et al. Do certain countries produce only positive results? A systematic review of controlled trials. Control Clin Trials, 1998, 19(2): 159-166.

1. 中国高血压防治指南起草委员会. 中国高血压防治指南. 高血压杂志, 2000, 8(1): 94-104.
2. WHO-ISH Hypertension Guidelines Committee. 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens, 1999, 17: 151-183.
3. 刘国仗, 胡大一, 陶萍, 等. 心血管药物临床试验评价方法的建议. 中华心血管杂志, 1998, 26(1): 7-9.
4. Sackett DL, Clarke M, Oxman AD, et al. Cochrane Reviewers, Handbook 4.2, In Review Manager. Versions 4.2 .Oxford, England: The cochrane collaboration, 2002. 13-36.
5. 房子婷, 魏莉娟. 左旋氨氯地平治疗原发性高血压的疗效和安全性评价. 医药论坛杂志, 2007, 28(9): 73-74.
6. 王文莉, 窦淑良, 张婉荣. 苯磺酸左旋氨氯地平治疗青年人原发性高血压52例疗效及不良反应观察. 陕西医学杂志, 2007, 36(5): 603-605.
7. 许钦荣. 苯磺酸左旋氨氯地平治疗原发性高血压临床分析. 心脑血管病防治, 2007, 7(2): 130-131.
8. 张臣, 刘翔, 钟广伟, 等. 氯沙坦与苯磺酸左旋氨氯地平治疗高血压病的疗效比较. 现代中西医结合杂志, 2007, 16(3): 302-304.
9. 伍三妹, 熊国红. 左旋氨氯地平与寿比山治疗原发性高血压的疗效比较. 医药世界, 2006, 12: 88-89.
10. 李颀. 左旋氨氯地平治疗轻中度高血压的临床研究. 中国血液流变学杂志, 2006, 16(3): 381-382.
11. 李玉杰. 北京降压0号治疗中青年轻中度高血压的疗效和安全性. 心血管康复医学杂志, 2006, 15(4): 378-380.
12. 乔玉香, 张合长. 左旋氨氯地平与依那普利治疗原发性高血压的临床对比研究. 中原医刊, 2006, 33(9): 73-74.
13. 汪斌, 于凤兰. 施慧达与拜心同治疗原发性高血压的疗效比较. 中国保健, 2006, 14(6): 69-70.
14. 潘正赛. 苯磺酸左旋氨氯地平治疗轻中度高血压的临床观察. 中外健康文摘•医药学刊, 2006, 3(1): 39-39.
15. 何伟珍, 吕干新. 多沙唑嗪与左旋氨氯地平治疗原发性高血压的疗效和安全性. 心脑血管病防治, 2005, 5(3): 48-50.
16. 郑煜, 徐冰. 苯磺酸左旋氨氯地平和硝苯地平治疗轻中度原发性高血压的疗效观察. 实用医技杂志, 2004, 11(9A): 1726-1728.
17. 杨青. 苯磺酸左旋氨氯地平治疗轻、中度高血压临床观察. 宁夏医学杂志, 2004, 26(6): 353-354.
18. 郭冀珍, 钱岳晟, 陶波, 等. 苯磺酸左旋氨氯地平和氯沙坦治疗140例原发性高血压患者的比较. 中国新药与临床杂志, 2003, 22(12): 766-769.
19. 方根强, 陈燕惠, 王一尘, 等. 左旋氨氯地平治疗原发性轻中度高血压病的疗效及安全性评价. 中国综合临床, 2003, 19(10): 897-898.
20. 胡大一, 赵秀丽. 苯磺酸左旋氨氯地平与苯磺酸氨氯地平治疗原发性轻中度高血压的随机、双盲平行研究. 中国医刊, 2002, 37(5): 46-47.
21. 刘国树, 王可. 氨氯地平与左旋氨氯地平治疗夜间高血压疗效比较. 医学研究生学报, 2001, 14(6): 496-498.
22. Vickers A, Goyal N, Harland R, et al. Do certain countries produce only positive results? A systematic review of controlled trials. Control Clin Trials, 1998, 19(2): 159-166.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Levoamlodipine Besylate for Essential Hypertension: A Systematic Review

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