背景:高血压是2017年最常见的死亡原因。高血压分为原发性或原发性高血压和继发性高血压两种类型。培多普利-氨氯地平组合在降低血压升高和心血管并发症方面显示出显着效果。
目的:评价固定剂量的培多普利-氨氯地平单药联合治疗高血压患者的疗效和安全性。
方法:我们搜索了PubMed,Medline,Scopus,和WebofScience进行相关临床试验。根据GRADE进行质量评估,并使用Cochrane的偏倚风险工具评估偏倚风险。我们包括以下结果:收缩压,舒张压,脉压,平均血压,心率,咳嗽,头晕,头痛,和外周水肿。我们在固定效应模型下对同质数据进行了分析,在随机效应模型下对异构数据进行分析。我们根据剂量进行了荟萃回归。
结果:我们纳入了10项临床试验。汇总分析表明,收缩压显着降低,舒张压,脉冲凹陷,平均血压,和心率后的培多普利-氨氯地平组合(MD=18.96[14.32,23.60],P<0.0001),(MD=11.90[8.45,15.35],P<0.0001),(MD=8.44[6.91,9.97],P=0.0001),(MD=13.07[5.86,20.29],P=0.0004),和(MD=2.93[0.89,4.96],P=0.005),分别。荟萃回归结果显示,增加剂量可增加疗效(P<0.001)。DBP,平均血压,脉压,和HR。
BACKGROUND: Hypertension represent the commonest cause of death in 2017. Hypertension is classified into two types which are primary or essential hypertension and secondary hypertension. The perindopril-amlodipine combination showed a significant effect in reduction of the elevated BP and the cardiovascular complications.
OBJECTIVE: To evaluate the efficacy and safety of a fixed-dose single-pill combination of perindopril-amlodipine in hypertensive patients.
METHODS: We searched PubMed, Medline, SCOPUS, and Web of Science for relevant clinical trials. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using Cochrane\'s risk of bias tool. We included the following outcomes: systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, heart rate, cough, dizziness, headache, and peripheral edema. We performed the analysis of homogeneous data under the fixed-effects model, while analysis of heterogeneous data was analyzed under the random-effects model. We conducted a meta-regression according to the dose.
RESULTS: We included ten clinical trials. The pooled analysis showed that there was a significant reduction of the systolic blood pressure, diastolic blood pressure, pulse plessure, mean blood pressure, and heart rate after the the perindopril-amlodipine combination (MD = 18.96 [14.32, 23.60], P < 0.0001), (MD = 11.90 [8.45, 15.35], P < 0.0001), (MD = 8.44 [6.91, 9.97], P = 0.0001), (MD = 13.07 [5.86, 20.29], P = 0.0004), and (MD = 2.93 [0.89, 4.96], P = 0.005), respectively. The results of the meta-regression revealed that the efficacy is increased by increasing the dose (P < 0.001) CONCLUSION: The use of the perindopril-amlodipine combination had a significant effect on the reduction of SBP, DBP, mean blood pressure, pulse pressure, and HR.