Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(8), 886–898. https://doi.org/10.1002/clc.24082 Mengxin Xie et al.
Points
- The research paper evaluates the effectiveness of single-pill combination (SPC) antihypertensive drugs for uncontrolled essential hypertension in a cohort of 16,273 patients from randomized controlled trials.
- The authors meticulously searched databases, such as Pubmed, EMBASE, Cochrane Library, and Web of Science, covering studies published until July 2022.
- Their methodology involved assessing the methodological quality of selected studies using the Cochrane Risk of Bias Assessment and conducting statistical analyses with Review Manager 5.3 and Stata 15.1 software.
- Notable SPC antihypertensive drugs, including Irbesartan/amlodipine, Amlodipine/losartan, and Telmisartan/amlodipine, showed strong performance in reducing systolic and diastolic blood pressure and blood pressure control rates.
- The overarching conclusion indicates that SPC antihypertensive drugs are more effective than monotherapy, with the combination of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) particularly excelling in various blood pressure-related parameters. However, some limitations in the available data warrant caution in interpretation.
Summary
In their extensive research paper, the authors conducted a comprehensive investigation to evaluate the efficacy of single-pill combination (SPC) antihypertensive drugs in patients with uncontrolled essential hypertension. This research endeavor entailed a meticulous search process, which involved scouring through prominent databases such as Pubmed, EMBASE, the Cochrane Library, and Web of Science. The focus was explicitly on randomized controlled trials that explored the utility of SPC antihypertensive drugs. This thorough investigation covered a time frame from the databases’ inception to July 2022.
Each of the selected studies underwent scrutiny for methodological quality using the Cochrane Risk of Bias Assessment, and subsequent statistical analyses were performed utilizing Review Manager 5.3 and Stata 15.1 software. This review ultimately encompassed 32 references, involving a substantial cohort of 16,273 patients grappling with uncontrolled essential hypertension.
Notably, the outcome of the network meta-analysis cast the spotlight on a diverse array of 11 SPC antihypertensive drugs. Irbesartan/amlodipine exhibited exceptional prowess in diminishing systolic blood pressure, boasting a SUCRA value of 92.2%. On the other hand, Amlodipine/losartan emerged as the frontrunner in reducing diastolic blood pressure, registering a commanding SUCRA of 95.1%. Telmisartan/amlodipine showcased a prominent SUCRA of 83.5% for its remarkable blood pressure control rates. In addition, Amlodipine/losartan exhibited a SUCRA of 84.5%, indicating its prominence in diastolic response rates. These findings underpin the overarching conclusion that SPC antihypertensive drugs outperform monotherapy. Notably, the combination of angiotensin receptor blockers (ARBs) with calcium channel blockers (CCBs) demonstrated a pronounced advantage, exhibiting superior performance in systolic and diastolic blood pressure reduction, blood pressure control rates, and diastolic response rates.
It is crucial to approach these findings with caution. The authors acknowledged that the limited availability of studies for some drugs and the absence of relevant data could potentially introduce biases that may influence the overall interpretation. Therefore, readers are strongly advised to exercise circumspection when interpreting these results, bearing in mind the limitations in the existing body of research on this subject.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24082
References Xie, M., Tang, T., & Liang, H. (2023). Efficacy of single‐pill combination in uncontrolled essential hypertension: A systematic review and network meta‐analysis. Clinical Cardiology, 46(8), 886–898. https://doi.org/10.1002/clc.24082
