■高血压和临床并发症的发生率(例如,心,脑血管和肾脏损伤)在全球范围内增加。众所周知,相对较大剂量的缬沙坦(320mg)可以减轻临床并发症。当前的网络荟萃分析评估了哪种药物可以与相对大剂量的缬沙坦联合使用以更有效地控制血压(BP)。不同剂量缬沙坦的联合治疗不会随着缬沙坦剂量的增加而导致血压过度降低。
■PubMed,Embase,Medline,科克伦图书馆,CNKI,万方,和CSTJ数据库从开始到2022年10月检索相关随机对照试验(RCT).搜索策略包括与高血压相关的概念和不同剂量缬沙坦的两种药物联合治疗。没有语言或数据限制。结果包括不良反应以及收缩压和舒张压的变化。与治疗相关的永久停药是最准确和客观的不良反应衡量标准。大多数研究的常见不良反应(即,头晕,头痛,鼻咽炎,虚弱和荨麻疹)也包括在内。进行了贝叶斯网络荟萃分析,并计算95%置信区间的平均差.使用ADDIS和STATA进行贝叶斯模型网络元计算。
■纳入了34个RCT,涉及26,752名患者,干预措施包括不同剂量的缬沙坦联合各种类型和剂量的药物。在许多联合疗法中,缬沙坦320mg与氨氯地平10mg(p<0.01)合用,降压效果最佳,无明显不良反应。与缬沙坦80mg和160mg相比,缬沙坦320mg联合氢氯噻嗪25mg(p>0.05)未进一步降低血压,且未显示增加不良反应发生率。
■大剂量缬沙坦联合治疗可有效控制血压,改善临床并发症。然而,针对不同治疗要求的高血压患者,是否控制BP应做出具体选择,治疗临床并发症,或者两者兼而有之。
UNASSIGNED: The incidence of hypertension and clinical complications (e.g., heart, cerebrovascular and kidney injury) is increasing worldwide. It is widely known that a relatively large dose of valsartan (320 mg) could alleviate clinical complications. The current network meta-analysis assessed which drug could be combined with a relatively large dose of valsartan to control blood pressure (BP) more effectively. And which combination therapy with different dosages of valsartan did not induce excessive BP reduction with increasing dosages of valsartan.
UNASSIGNED: The PubMed, Embase, Medline, Cochrane Library, CNKI, Wanfang, and CSTJ databases were searched from inception to October 2022 for relevant randomized controlled trials (RCTs). The search strategies included concepts related to hypertension and two-drug combination therapy of different doses of valsartan, and there were no language or data restrictions. The outcomes included adverse effects and changes in systolic BP and diastolic BP. Permanent discontinuations related to treatment were the most accurate and objective measure of adverse effects. The common adverse effects of most studies (i.e., dizziness, headache, nasopharyngitis, asthenia and urticaria) were also included. A Bayesian network meta-analysis was performed, and mean differences with 95% confidence intervals were calculated. ADDIS and STATA were used for Bayesian model network meta-calculation.
UNASSIGNED: Thirty-four RCTs were included involving 26,752 patients, and the interventions included different doses of valsartan combined with various types and doses of drugs. Among many combination therapies, the combination of valsartan 320 mg with amlodipine 10 mg (p < 0.01) had the best antihypertensive effect without significant adverse effects. Compared with valsartan 80 mg and 160 mg, valsartan 320 mg combined with hydrochlorothiazide 25 mg (p > 0.05) did not further reduce BP and was not shown to increase the incidence of adverse effects.
UNASSIGNED: Combination therapy with a relatively large dose of valsartan could control BP and improve clinical complications effectively. However, for hypertensive patients with different treatment requirements, specific choices should be made regarding whether to control BP, treat clinical complications, or both.