Global Guidelines Concerning Pharmacological Intervention for Complicated Hypertension: A Systematic R⑩eview_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Yin ^1,2 , HU Shilian ² ,  LI Youping ¹ , SHEN Gan ³ , YAN Boxi ⁴ , WANG Li ¹

1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;2. Anhui Evidence-Based Medicine Center, Anhui Provincial Hospital, Hefei 230001, China;3. Anhui Provincial Committee Hospital, Hefei 230001, China;4. West China School of Stomatology, Sichuan University, Chengdu 610041, China;

Corresponding author：

LI Youping, Email: yzmylab@hotmail.com

Keywords：

Complicated hypertension; Coronary heart disease; Stroke; Diabetes mellitus; Kidney disease; Pharmacological intervention; Guideline; Systematic review

DOI：

10.7507/1672-2531.20120225

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To systematically review the methodological quality of guidelines concerning pharmacological intervention for complicated hypertension.
Methods 　The databases and relevant guideline websites such as MEDLINE, EMbase, CBM, WangFang Data, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE) and Clinical Practice Guideline Network (CPGN) were searched to collect the clinical guidelines concerning pharmacological intervention for complicated hypertension. By adopting the Appraisal of Guidelines for Research and Evaluation (AGREE), the methodological quality of guidelines was assessed. Meanwhile the similarities, differences and features of drug recommendation in guidelines for different areas and diseases were analyzed by means of analogy comparison.
Results 　A total of 21 guidelines concerning pharmacological intervention for complicated hypertension were included. The number of guidelines concerning hypertension complicated with coronary heart disease (CHD), stroke, diabetes mellitus (DM) and kidney disease (KD) was 5, 5, 7 and 4, respectively. The publication year ranged from 2000 to 2011. According to the AGREE instrument, 19 and 2 guidelines were graded as Level B and C, respectively. The overall guidelines got low average scores in the domain of “Stakeholder involvement” and “Applicability”, including 9 evidence-based guidelines. There were totally 4 and 3 classes in terms of the level of evidence and recommendation, respectively; moreover, 10 and 6 expression forms were adopted in the level of evidence and recommendation, respectively. For hypertension with angina pectoris, -blocker (BB) and calcium channel blocker (CCB) were recommended unanimously. For hypertension with myocardial infarction, angiotensin converting enzyme inhibitor (ACEI) and BB were recommended unanimously. For hypertension with heart failure, ACEI, angiotensin-receptor blocker (ARB) and BB were recommended unanimously. For hypertension with later stage of post-stroke, 76.47% guidelines recommended diuretic (D) and ACEI. For hypertension with acute stroke, recommendations were mainly based on the guidelines developed by American Heart Association/American Stroke Association (AHA/ASA). For hypertension with DM or KD, the guidelines basically recommended that systolic/diastolic pressure should be controlled in the range of less than 130/80 mmHg. For hypertension with DM, ACEI were recommended unanimously, followed by D and CCB. For hypertension with KD, ACEI/ARB was recommended, while 3 of the 5 guidelines recommending CCB were from Asian.
Conclusion 　The overall methodological qualities of complicated hypertension guidelines differs, with high proportion of evidence-based guidelines. The classification criteria of the levels of evidence and recommendation are still suboptimal. For hypertension with CHD, DM, KD and later stage of stroke, results from high quality clinical evidence are consistent, and the recommendations are basically unanimous, with no regional and quality difference. But in some clinical researches beyond reaching a consensus at present, the recommendation discrepancy exists, and there still remains controversy for hypertension with acute stroke.

Citation： CHEN Yin,HU Shilian,LI Youping,SHEN Gan,YAN Boxi,WANG Li. Global Guidelines Concerning Pharmacological Intervention for Complicated Hypertension: A Systematic R⑩eview. Chinese Journal of Evidence-Based Medicine, 2012, 12(12): 1446-1462. doi: 10.7507/1672-2531.20120225 Copy

1.	Ogihara T, Kikuchi K, Matsuoka H, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res, 2009, 32(1): 3-107.
2.	邓可刚. 循证医学证据的检索与利用(第2版). 北京: 人民卫生出版社, 2005. 15.
3.	陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10): 1180-1194.
4.	Taylor R, Giles J. Cash interests taint drug advice. Nature, 2005, 437(7062): 1070-1071.
5.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454):1490.
6.	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
7.	Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ, 2008, 336(7652): 1049-1051.
8.	Schünemann HJ, Oxman AD, Brozek J, et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ, 2008, 336(7653): 1106-1110.
9.	Mulrow CD. Rationale for systematic reviews. BMJ, 1994, 309(6954): 597-599.
10.	Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ, 2009, 338: b1665.
11.	Tomlinson B, Dalal JJ, Huang J, et al. The role of β-blockers in the management of hypertension: an Asian perspective. Curr Med Res Opin, 2011, 27(5):1021-1033.
12.	中华医学会心血管病学分会, 黄峻. β肾上腺素能受体阻滞剂在心血管疾病应用专家共识. 中华心血管病杂志, 2009, 37(3):195-209.
13.	Detry JM, Lichtlen PR, et al. Amlodipine reduces transient myocardial ischemia in patients with coronary artery disease: double-blind Circadian Anti-Ischemia Program in Europe (CAPE Trial). J Am Coll Cardiol, 1994, 24(6): 1460-1467.
14.	Lenfant C. The calcium channel blocker scare. Lessons for the future. Circulation, 1995, 91(12): 2855-2856.
15.	Poole-Wilson PA, Lubsen J, Kirwan BA, et al. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Lancet, 2004, 364(9437): 849-857.
16.	Yui Y, Sumiyoshi T, Kodama K, et al. Comparison of nifedipine retard with angiotensin converting enzyme inhibitors in Japanese hypertensive patients with coronary artery disease: the Japan Multicenter Investigation for Cardiovascular Diseases-B (JMIC-B) randomized trial. Hypertens Res, 2004, 27(3): 181-191.
17.	Nissen SE, Tuzcu EM, Libby P, et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary heart disease and normal blood pressure. The CAMELOT study: a randomized controlled trial. JAMA, 2004, 292(18): 2217−2226.
18.	Pitt B, Byington RP, Furberg CD, et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. PREVENT Investigators. Circulation, 2000, 102(13): 1503-1510.
19.	Staessen JA, Li Y, Thijs L, et al. Blood pressure reduction and cardiovascular prevention: an update including the 2003-2004 secondary prevention trials. Hypertens Res, 2005, 28(5): 385-407.
20.	Sever PS, Poulter NR, Elliott WJ, et al. Blood pressure reduction is not the only determinant of outcome. Circulation, 2006, 113(23): 2754-2772.
21.	Elkayam U, Amin J, Mehra A, et al. A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure. Circulation, 1990, 82(6): 1954-1961.
22.	Barjon JN, Rouleau JL, Bichet D, et al. Chronic renal and neurohumoral effects of the calcium entry blocker nisoldipine in patients with congestive heart failure. J Am Coll Cardiol, 1987, 9(3): 622-630.
23.	Packer M, O’Connor CM, Ghali JK, et al. Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group. N Engl J Med, 1996, 335(15): 1107-1114.
24.	Dahlof B, Sever PS, Poulter NR, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo–Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm (ASCOT–BPLA): a multicentre randomized controlled trial. Lancet, 2005, 366(9489): 895-906.
25.	Pfeffer MA, Braunwald E, Moyé LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction.Results of the survival and ventricular enlargement trial. N Engl J Med, 1992, 327(10): 669-677.
26.	The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med, 1991, 325(5): 293-302.
27.	Swedberg K, Held P, Kjekshus J, et al. Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction. Results of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II). N Engl J Med, 1992, 327(10): 678-684.
28.	No authors listed. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality andventricular function after acute myocardial infarction. Gruppo Italiano per lo Studio della Sopravvivenza nell’infarto Miocardico. Lancet, 1994, 343(8906): 1115-1122.
29.	ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet, 1995, 345(8951): 669-685.
30.	No authors listed. Oral captopril versus placebo among 13,634 patients with suspected acute myocardial infarction: interim report from the Chinese Cardiac Study (CCS-1). Lancet, 1995, 345(8951): 686-687.
31.	The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators.Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet, 1993, 342(8875): 821-828.
32.	Ambrosioni E, Borghi C, Magnani B. The effect of the angiotensin converting enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. The Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study Investigators. N Engl J Med, 1995, 332(2): 80-85.
33.	Køber L, Torp-Pedersen C, Carlsen JE, et al. A clinical trial of the angiotensin converting enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group. N Engl J Med, 1995, 333(25): 1670-1676.
34.	Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet, 2003, 362(9386): 782-788.
35.	Dagenais GR, Pogue J, Fox K, et al. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet, 2006, 368(9535): 581-588.
36.	Philipp T, Anlauf M, Distler A, et al. Randomised double blind multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study. BMJ, 1997, 315(7101): 154-159.
37.	Rocha R, Williams GH. Rationale for the use of Aldosterone antagonists in congestive heart failure. Drugs, 2002, 62(5): 723-731.
38.	Pitt B, Zannad F, Remme WJ, et al. The effect of spir onolactone on morbidity and mortality in patients with severe heart failure.Randomized Aldactone Evaluation Study Investigators. N Engl J Med, 1999, 341(10): 709-717.
39.	Pitt B, Bakris G, Ruilope LM, et al. Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation, 2008, 118(16): 1643-1650.
40.	PATS Collaborating Group. Post-stroke antihypertensive treatment study. A preliminary result. Chin Med J (Engl), 1995, 108(9): 710-717.
41.	PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet, 2001, 358(9287): 1033-1041.
42.	Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med, 2000, 342(3): 145-153.
43.	Schrader J, Lüders S, Kulschewski A, et al. Morbidity and Mortality After Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke, 2005, 36(6): 1218-1226.
44.	Yusuf S, Diener HC, Sacco RL, et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med, 2008, 359(12): 1225-1237.
45.	Anderson CS, Huang Y, Wang JG, et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol, 2008, 7(5): 391-399.
46.	Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol, 2010, 67(5): 570-576.
47.	Pahor M, Psaty BM, Alderman MH, et al. Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes. Diabetes Care, 2000, 23(7): 888-892.
48.	Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin Converting Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N Engl J Med, 1996, 334: 939-945.
49.	Hou FF, Zhang X, Zhang GH, et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N Engl J Med, 2006, 354(15): 131-140.
50.	Teo K, Yusuf S, Sleight P, et al. Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND) trials. Am Heart J, 2004, 148(1): 52-61.

1. Ogihara T, Kikuchi K, Matsuoka H, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res, 2009, 32(1): 3-107.
2. 邓可刚. 循证医学证据的检索与利用(第2版). 北京: 人民卫生出版社, 2005. 15.
3. 陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10): 1180-1194.
4. Taylor R, Giles J. Cash interests taint drug advice. Nature, 2005, 437(7062): 1070-1071.
5. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454):1490.
6. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
7. Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ, 2008, 336(7652): 1049-1051.
8. Schünemann HJ, Oxman AD, Brozek J, et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ, 2008, 336(7653): 1106-1110.
9. Mulrow CD. Rationale for systematic reviews. BMJ, 1994, 309(6954): 597-599.
10. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ, 2009, 338: b1665.
11. Tomlinson B, Dalal JJ, Huang J, et al. The role of β-blockers in the management of hypertension: an Asian perspective. Curr Med Res Opin, 2011, 27(5):1021-1033.
12. 中华医学会心血管病学分会, 黄峻. β肾上腺素能受体阻滞剂在心血管疾病应用专家共识. 中华心血管病杂志, 2009, 37(3):195-209.
13. Detry JM, Lichtlen PR, et al. Amlodipine reduces transient myocardial ischemia in patients with coronary artery disease: double-blind Circadian Anti-Ischemia Program in Europe (CAPE Trial). J Am Coll Cardiol, 1994, 24(6): 1460-1467.
14. Lenfant C. The calcium channel blocker scare. Lessons for the future. Circulation, 1995, 91(12): 2855-2856.
15. Poole-Wilson PA, Lubsen J, Kirwan BA, et al. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Lancet, 2004, 364(9437): 849-857.
16. Yui Y, Sumiyoshi T, Kodama K, et al. Comparison of nifedipine retard with angiotensin converting enzyme inhibitors in Japanese hypertensive patients with coronary artery disease: the Japan Multicenter Investigation for Cardiovascular Diseases-B (JMIC-B) randomized trial. Hypertens Res, 2004, 27(3): 181-191.
17. Nissen SE, Tuzcu EM, Libby P, et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary heart disease and normal blood pressure. The CAMELOT study: a randomized controlled trial. JAMA, 2004, 292(18): 2217−2226.
18. Pitt B, Byington RP, Furberg CD, et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. PREVENT Investigators. Circulation, 2000, 102(13): 1503-1510.
19. Staessen JA, Li Y, Thijs L, et al. Blood pressure reduction and cardiovascular prevention: an update including the 2003-2004 secondary prevention trials. Hypertens Res, 2005, 28(5): 385-407.
20. Sever PS, Poulter NR, Elliott WJ, et al. Blood pressure reduction is not the only determinant of outcome. Circulation, 2006, 113(23): 2754-2772.
21. Elkayam U, Amin J, Mehra A, et al. A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure. Circulation, 1990, 82(6): 1954-1961.
22. Barjon JN, Rouleau JL, Bichet D, et al. Chronic renal and neurohumoral effects of the calcium entry blocker nisoldipine in patients with congestive heart failure. J Am Coll Cardiol, 1987, 9(3): 622-630.
23. Packer M, O’Connor CM, Ghali JK, et al. Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group. N Engl J Med, 1996, 335(15): 1107-1114.
24. Dahlof B, Sever PS, Poulter NR, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo–Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm (ASCOT–BPLA): a multicentre randomized controlled trial. Lancet, 2005, 366(9489): 895-906.
25. Pfeffer MA, Braunwald E, Moyé LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction.Results of the survival and ventricular enlargement trial. N Engl J Med, 1992, 327(10): 669-677.
26. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med, 1991, 325(5): 293-302.
27. Swedberg K, Held P, Kjekshus J, et al. Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction. Results of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II). N Engl J Med, 1992, 327(10): 678-684.
28. No authors listed. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality andventricular function after acute myocardial infarction. Gruppo Italiano per lo Studio della Sopravvivenza nell’infarto Miocardico. Lancet, 1994, 343(8906): 1115-1122.
29. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet, 1995, 345(8951): 669-685.
30. No authors listed. Oral captopril versus placebo among 13,634 patients with suspected acute myocardial infarction: interim report from the Chinese Cardiac Study (CCS-1). Lancet, 1995, 345(8951): 686-687.
31. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators.Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet, 1993, 342(8875): 821-828.
32. Ambrosioni E, Borghi C, Magnani B. The effect of the angiotensin converting enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. The Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study Investigators. N Engl J Med, 1995, 332(2): 80-85.
33. Køber L, Torp-Pedersen C, Carlsen JE, et al. A clinical trial of the angiotensin converting enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group. N Engl J Med, 1995, 333(25): 1670-1676.
34. Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet, 2003, 362(9386): 782-788.
35. Dagenais GR, Pogue J, Fox K, et al. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet, 2006, 368(9535): 581-588.
36. Philipp T, Anlauf M, Distler A, et al. Randomised double blind multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study. BMJ, 1997, 315(7101): 154-159.
37. Rocha R, Williams GH. Rationale for the use of Aldosterone antagonists in congestive heart failure. Drugs, 2002, 62(5): 723-731.
38. Pitt B, Zannad F, Remme WJ, et al. The effect of spir onolactone on morbidity and mortality in patients with severe heart failure.Randomized Aldactone Evaluation Study Investigators. N Engl J Med, 1999, 341(10): 709-717.
39. Pitt B, Bakris G, Ruilope LM, et al. Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation, 2008, 118(16): 1643-1650.
40. PATS Collaborating Group. Post-stroke antihypertensive treatment study. A preliminary result. Chin Med J (Engl), 1995, 108(9): 710-717.
41. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet, 2001, 358(9287): 1033-1041.
42. Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med, 2000, 342(3): 145-153.
43. Schrader J, Lüders S, Kulschewski A, et al. Morbidity and Mortality After Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke, 2005, 36(6): 1218-1226.
44. Yusuf S, Diener HC, Sacco RL, et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med, 2008, 359(12): 1225-1237.
45. Anderson CS, Huang Y, Wang JG, et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol, 2008, 7(5): 391-399.
46. Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol, 2010, 67(5): 570-576.
47. Pahor M, Psaty BM, Alderman MH, et al. Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes. Diabetes Care, 2000, 23(7): 888-892.
48. Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin Converting Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N Engl J Med, 1996, 334: 939-945.
49. Hou FF, Zhang X, Zhang GH, et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N Engl J Med, 2006, 354(15): 131-140.
50. Teo K, Yusuf S, Sleight P, et al. Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND) trials. Am Heart J, 2004, 148(1): 52-61.

Chinese Journal of Evidence-Based Medicine

Global Guidelines Concerning Pharmacological Intervention for Complicated Hypertension: A Systematic R⑩eview

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