Objective To assess the efficacy and safety Losartan for essential hypertension associated withhyperuricemia. Methods Included randomized controlled trials of Losartan versus Valsartan. Electronic searchconducted in CENTRAL, the Cochrane Library (until 2008, Issue 4), PubMed, EMBASE, Chinese Biomedicine database,Chinese Scientific Journals Full-text Database, and China Journal Full-text Database (until 2008, Issue 10). Two reviewers extracted data independently. RevMan 5.0 software developed by the Cochrane Collaboration was used for Metaanalysis.Results Only 7 trials with 1 136 eligible patients were included in the systematic review. Meta-analysis showedno significant difference in reductions of systolic blood pressure, diastolic blood pressure, and adverse events betweenLosartan and Valsartan groups. However, a significant difference of serum uric acid reduction was observed betweenLosartan and Valsartan group. Losartan play a significant role of decreased serum uric acid levels. Conclusions Based on this systematic review, Losartan is effective and well tolerated in reducing BP and serum uric acid levels. Further large randomized, double blind, placebo controlled trials are needed in long-term safety and efficacy and different subgroups of Losartan.
Objective To observe the effects of valsartan/ hydrochlorothiazide and valsartan on left ventricular thickness and the left ventricular diastolic function in patients with essential hypertension and left ventricular hypertrophy and impaired left ventricular diastolic function. Methods 56 patients of essential hypertension with left ventricular hypertrophy and impaired left ventricular diastolic function were randomized into two randomized double-blind groups, valsartan/hydrochlorothiazide (HCTZ) 80/12.5 mg o.d were gave to A group and valsartan 80 mg o.d were gave to B group. The dosage would be doubled in patients whose SDBP ≥ 12 kPa or SSBP ≥ 18.7 kPa after 4 weeks. Treatment lasted for 6 months. Result At the end of 6 months, valsartan/ hydrochlorothiazide and valsartan significantly reduced BP from baseline (Plt;0.01), there was significant difference in reducing BP between the two groups (Plt;0.05). Indexes of left ventricular diastolic function (IVST, LVPWT, LVMI) significantly decreased (Plt;0.01). LVEF increased significantly (Plt;0.01). There was significant difference in IVST, LVPWT, LVMI and LVEF between two groups (Plt;0.05). Conclusion Valsartan/ hydrochlorothiazide (HCTZ) can not only decrease blood pressure effectively, but also can significantly improve left ventricular hypertrophy and left ventricular diastolic function.
目的:观察缬沙坦治疗前、后高血压合并糖尿病患者血清脂联素的变化。方法:将我院高血压合并糖尿病患者60例随机分为两组,然后分别给予缬沙坦或氨氯地平治疗至少8周,分析治疗前、后两组间的血清脂联素变化。结果:与治疗前相比较,缬沙坦组显著降低了血清脂联素(Plt;0.01),而氨氯地平组治疗前、后的脂联素改变无显著差异性。结论:与氨氯地平比较,缬沙坦在降压的同时,显著降低了血清脂联素水平。
目的:观察缬沙坦逆转轻中度原发性高血压左室肥厚的疗效。方法:采用自身对照试验, 116 例轻中度原发性高血压伴左室肥厚的患者, 服用缬沙坦80～160mg/d, 共36 周, 随访患者血压、超声心动图及不良反应。结果: 116例患者治疗后血压明显下降(Plt;0.05), 左心室舒末内径(LVDd)、室间隔厚度(IVST) 、心室后壁厚度(PWT) 、左室重指数(LVMI) 均明显减少 (P 均lt;0.01),无明显不良反应。结论: 缬沙坦治疗轻中度原发性高血压疗效确切, 有效逆转左室肥厚。
ObjectiveTo systematically review the efficacy of amlodipine versus valsartan in the treatment of diabetes mellitus combined with hypertension and renal impairment. MethodsAll relevant randomized controlled trials (RCTs) were retrieved in WanFang Data, CNKI, VIP, CBM, The Cochrane Library (Issue 10, 2013), PubMed, EMbase and Ovid up to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2. ResultsNine RCTs were finally included involving 794 cases. The results of meta-analysis showed that amlodipine was better than valsartan in improving 24-hour proteinuria (basic level < 1 000 mg:WMD=-10.24, 95%CI-18.52 to-1.95, P=0.02; basic level > 1 000 mg:WMD=-575.69, 95%CI-781.02 to-370.36, P < 0.000 01). However, there was no significant difference between two groups in lowing urine albumin excretion rates (UAER), serum creatinine (Scr), systolic blood pressure (SBP), diastolic blood pressure (DBP), and incidences of adverse events (UAER:WMD=-11.29, 95%CI-27.93 to 5.36, P=0.18; Scr:WMD=1.05, 95%CI-3.89 to 5.99, P=0.68; SBP:WMD=0.52, 95%CI-0.83 to 1.87, P=0.45; DBP:WMD=-0.40, 95%CI-1.41 to 0.62, P=0.44; ADR:WMD=1.00, 95%CI 0.3 to 3.34, P=1.00). ConclusionCurrent evidence shows that, compared with valsartan, amlodipine has the same efficacy in treatment of diabetes mellitus combined with hypertension and renal impairment, and it is even better in improving 24-hour proteinuria.
ObjectiveTo systematically review the efficacy and safety of sacubitri valsartan in the treatment of hypertension. MethodsPubMed, ClinicalTrials.gov, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of sacubitril valsartan in the treatment of hypertension from inception to August 31, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 13.0 software. ResultsA total of 11 RCTs involving 3 564 patients were included. Meta-analysis showed that compared with control group, sitting systolic blood pressure (MD=−6.85, 95%CI −9.94 to −3.76, P<0.01) and sitting diastolic blood pressure (MD=−3.70, 95%CI −5.61 to −1.79, P<0.01) significantly decreased in the experimental group, and the difference was statistically significant. The results of subgroup analysis did not show significant changes. At the same time, the incidence of adverse reactions with sacubitril valsartan was low, and no fatal adverse events were observed. ConclusionCurrent evidence shows that sacubitril valsartan in the treatment of hypertension has definite efficacy and fewer adverse reactions. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.