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The blood pressure lowering potential of sulodexide – a systematic review and meta‐analysis
Author(s) -
Olde Engberink Rik H. G.,
Rorije Nienke M. G.,
Lambers Heerspink Hiddo J.,
De Zeeuw Dick,
Born BertJan H.,
Vogt Liffert
Publication year - 2015
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12722
Subject(s) - medicine , diastole , albuminuria , blood pressure , population , cardiology , endocrinology , environmental health
Aims Sulodexide is a highly purified mixture of glycosaminoglycans that has been studied for its anti‐albuminuric potential. Considering the effects of glycosaminoglycans on endothelial function and sodium homeostasis, we hypothesized that sulodexide may lower blood pressure (BP). In this meta‐analysis, we therefore investigated the antihypertensive effects of sulodexide treatment. Methods We selected randomized controlled trials that investigated sulodexide treatment of at least 4 weeks and measured BP at baseline and after treatment. Two reviewers independently extracted data on study design, risk of bias, population characteristics and outcome measures. In addition, we contacted authors and pharmaceutical companies to provide missing data. Results Eight studies, totalling 3019 subjects (mean follow‐up 4.4 months) were included. Mean age was 61 years and mean baseline BP was 135/75 mmHg. Compared with control treatment, sulodexide resulted in a significant systolic (2.2 mmHg [95% CI 0.3, 4.1], P = 0.02) and diastolic BP reduction (1.7 mmHg [95% CI 0.6, 2.9], P = 0.004). Hypertensive patients displayed the largest systolic BP and diastolic BP reductions (10.2/5.4 mmHg, P < 0.001). Higher baseline systolic and diastolic BP were significantly associated with larger systolic ( r 2 =0.83, P < 0.001) and diastolic BP ( r 2 =0.41, P = 0.02) reductions after sulodexide treatment. In addition, systolic ( r 2 =0.41, P = 0.03) and diastolic BP reductions ( r 2 =0.60, P = 0.005) were significantly associated with albuminuria reduction. Conclusion Our data suggest that sulodexide treatment results in a significant BP reduction, especially in hypertensive subjects. This indicates that endothelial glycosaminoglycans might be an independent therapy target in cardiovascular disease. Future studies should further address the BP lowering potential of sulodexide.