Open AccessRenin‐Angiotensin System Inhibitors vs Other Antihypertensives in Hypertensive Blacks: A Meta‐Analysis
Author(s) -
Palla Mohan,
Ando Tomo,
Androulakis Emmanuel,
Telila Tesfaye,
Briasoulis Alexandros
Publication year - 2017
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12867
Subject(s) - medicine , odds ratio , confidence interval , meta analysis , myocardial infarction , heart failure , stroke (engine) , cardiology , renin–angiotensin system , angiotensin converting enzyme , blood pressure , mechanical engineering , engineering
The purpose of this study was to assess the effects of renin‐angiotensin system ( RAS ) inhibitors vs other antihypertensive agents on cardiovascular outcomes in hypertensive black patients. The authors performed a systematic review and meta‐analysis of studies that compared the effects of angiotensin‐converting enzyme ( ACE ) inhibitors or angiotensin receptor blockers ( ARB s) with calcium channel blockers ( CCB s), diuretics, and β‐blockers in hypertensive black patients on cardiovascular outcomes. A total of 38,983 patients with a mean age of 60 years and mean follow‐up of 4 years were included in our meta‐analysis. No significant differences were found in all‐cause mortality, myocardial infarction, heart failure, and cardiovascular mortality rates among patients treated with RAS inhibitors compared with CCB s, diuretics, and β‐blockers. The incidence of stroke was significantly increased in patients treated with RAS inhibitors compared with CCB s (odds ratio, 1.56; 95% confidence interval, 1.31–1.87 [ P <.00001]; I 2 =0%) and diuretics (odds ratio, 1.59; 95% confidence interval, 1.16–2.17 [ P =.004]; I 2 =56%) but not β‐blockers.