hypertension

systematic review meta-analysis network meta-analysis

Select angioplastycholesterol lowering interventionantiplatelets drugangiotensin-receptor blockersrenin inhibitor intensive blood pressure controlanti hypertensive agentsrenal denervation all diseases requiring ACEi (HF, CHD, HT,...)All type of patientDiabetic patientselderly (60 years and more)nephropathyNasopharyngeal carcinomapatients undergoing dialysissecondary prevention in patients with CADPatient with prior MI or with history of CHD uncoded clinical condition ***post strokesubjects with pre-hypertension--- uncoded (null)very ederly (80 and more)       angiotensin-converting enzyme inhibitors direct renin inhibitor angioplastyangiotensin receptor blockerangiotensin-converting enzyme inhibitorsARBs vs ACEIsARBs+ACEIs vs ACEIsbeta-blockersbeta-blockers + diureticsbeta-blockers or diureticscalcium-channel blockersdirect renin inhibitordiureticsendopeptidase inhibitorsendothelin receptor antagonistintensive treatmentmulti-electrode renal denervationplatelet aggregation inhibitorsrenal denervationstatinsTreatment blood pressure target atorvastatinfluvastatinvarious diureticsamlodipinediltiazemnicardipinenidrendipinenifedipinenisoldipineverapamilvarious beta blockerscaptoprilenalaprilfosinoprillisinoprilramiprilvarious ACEIirbesartanlosartantelmisartanvalsartancandesartanaliskiren aspirinatenololcarvedilolchlorthalidonehydrochlorothiazide indapamideintensive blood pressure lowering strategiesisradipinelacidipineoxprenololpropranololthiazid diuretic vs control or placebovs medical therapyvs placebovs placebo or controlvs standard strategyvs ACEIs vs angiotensin receptor blockervs angiotensin-converting enzyme inhibitorsvs beta-blockersvs calcium blockersvs calcium-channel blockersvs diuretic + beta-blockervs diuretic and/or beta-blockervs diuretic or beta-blockervs diureticsvs standard target       elderlyhypertensive patientsnondiabetic kidney diseasetype 2 diabetes

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Group by Group by... nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition MA  in first nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in second nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in third	Description Synopsis Comparison Treatments Patients Characteristics Method Risk of bias References None Tools Indexation					Results Global trial result Main results All results All result tag NCT results	All cause death (281)stroke (fatal and non fatal) (233)Cardiovascular death (209)cardiovascular events (197)Heart failure (149)myocardial infarction (fatal and non fatal) (132)Coronary event (115)Fatal stroke (33)Diabetes onset (33)Fatal MI (26)End stage renal disease (25)Non fatal MI (18)non cardiovascular death (18)Serious adverse event (17)Non fatal stroke (15)Cancer (14)Adverse events leading to treatment discontinuation (11)any adverse event (11)microvascular events (8)Coronary death (8)Revascularization (7)Peripheral arterial disease (6)lung cancer (6)worsening renal failure (6)Angina (5)cardiac death (5)cancer related death (3)left ventricular hypertrophy (2)hypertension (1)Haemmorhagic stroke (1)Gastrointestinal Bleeding (1)Major gastrointestinal bleeding (1)Fatal bleeding (1)Coronary death and non fatal MI (1)MACE (1)Rhabdomyolysis (1)new-onset diabetes (1) Options Numeric bar chart forest plot medians
Trial	Studied trt	Control trt	patients	tags	ROB	Trial result	All cause death	stroke (fatal and non fatal)
angioplasty
not classified
EMMA, 1998	angioplasty	medical therapy				negative
SNRASCG, 1998	angioplasty	medical therapy			Exploratory	negative
DRASTIC, 2000	angioplasty	medical therapy			Exploratory	negative
ASTRAL, 2009	angioplasty	medical therapy			Risk of bias	negative
STAR, 2009	angioplasty	medical therapy			Risk of bias	negative
NITER, 2009	angioplasty	medical therapy				negative
angiotensin-receptor blockers
not classified
Suzuki, 2008	ARBs	control			Risk of bias	negative
Ruilope, 2010	LCZ696	placebo			Low risk of bias	-
IDNT (irbesartan vs amlodipine), 2001	irbesartan	amlodipine			Low risk of bias	negative
VALUE, 2004      NCT	valsartan	amlodipine			Low risk of bias	suggesting
DETAIL, 2004	telmisartan	enalapril			Low risk of bias	negative
OSCAR, 2011      NCT	olmesartan 40 mg	olmesartan 20 mg plus a calcium-channel blocker			Risk of bias	negative
candesartan
Takahashi, 2006	candesartan	control			Exploratory	negative
E-COST, 2005	candesartan	conventional treatment			Risk of bias	suggesting
E-COST-R, 2005	candesartan	conventional treatment			Risk of bias	negative
HIJ-CREATE, 2009	candesartan	conventional treatment			Risk of bias	suggesting
SCOPE, 2003	candesartan	placebo			Low risk of bias	negative
HIJ-CREATE, 2009	Candesartan	usual care			Risk of bias	-
CASE-J, 2008	candesartan	amlodipine			Risk of bias	suggesting
ALPINE, 2003	candesartan	hydrochlorothiazide			Low risk of bias	suggesting
captopril
VALIANT/Val+Cap, 2003	Valsartan + captopril	Captopril			Low risk of bias	negative
irbesartan
IDNT (irbesartan vs pbo), 2001	irbesartan	placebo			Low risk of bias	negative
IRMA 2, 2001	irbesartan	placebo			Low risk of bias	negative
losartan
RENAAL, 2001	losartan	placebo			Low risk of bias	-
LIFE, 2002	losartan	atenolol			Low risk of bias	suggesting
ELITE, 1997	Losartan	Captopril			Low risk of bias	suggesting
ELITE-II, 2000	Losartan	Captopril			Low risk of bias	negative
OPTIMAAL, 2001	Losartan	Captopril			Risk of bias	negative
ramipril
ONTARGET/Tel+Ram, 2008	Telmisartan + ramipril	Ramipril			Low risk of bias	negative
telmisartan
PROPHESS, 2008      NCT	telmisartan	placebo			Low risk of bias	negative
DETAIL, 2004	Telmisartan	Enalapril			Low risk of bias	negative
ONTARGET/Tel, 2008	Telmisartan	Ramipril			Low risk of bias	negative
valsartan
VALIANT/Val, 2003	Valsartan	Captopril			Low risk of bias	negative
anti hypertensive agents
not classified
Suzuki, 2008	ARBs	control			Risk of bias	negative
HOPE (diabetic subgroup), 2000	ACE inhibitors	placebo			Low risk of bias	suggesting
CASTEL (subgroup ), 1994	beta-blockers + diuretics	placebo				negative
STOP (subgroup ), 1991	beta-blockers or diuretics	placebo			Low risk of bias	negative
DORADO-AC	darusentan	placebo				-
DORADO, 2009    NCT	darusentan	placebo			Low risk of bias	-
USPHS, 1977	diuretic and rauwolfia serpentina	placebo			Low risk of bias	negative
MRC old, 1992	hydrochlorothiazide + amiloride	placebo				suggesting
Ruilope, 2010	LCZ696	placebo			Low risk of bias	-
ACCORD (blood pressure), 2010          NCT	intensive	usual			Risk of bias	suggesting
IDNT (irbesartan vs amlodipine), 2001	irbesartan	amlodipine			Low risk of bias	negative
NAGOYA HEART, 2011      NCT	valsartan	amlodipine			Risk of bias	negative
VALUE, 2004      NCT	valsartan	amlodipine			Low risk of bias	suggesting
ACCOMPLISH (diabetic subgroup), 2010        NCT	benazepril + amlodipine	benazepril + hydrochlorothiazide			Low risk of bias	suggesting
STOP-2 (ACEI vs CCB) (diabetic subgroup), 2000	ACE inhibitor	calcium-channel blocker			Exploratory	negative
NORDIL (diabetic subgroup), 2000	diltiazem	diuretic and/or beta-blocker			Exploratory	negative
STOP-2 (ACEI, diabetic subgroup), 2000	ACE inhibitor	diuretic or beta-blocker			Exploratory	negative
STOP-2 (CCB, diabetic subgroup), 2000	calcium-channel blocker	diuretic or beta-blocker			Exploratory	negative
STOP-2 (CCB vs diurectic or beta-blocker), 1999	felopidine or israpidine	diuretic or beta-blocker				suggesting
DETAIL, 2004	telmisartan	enalapril			Low risk of bias	negative
OSCAR, 2011      NCT	olmesartan 40 mg	olmesartan 20 mg plus a calcium-channel blocker			Risk of bias	negative
AASK (amlodipine vs ramipril), 2002	amlodipine	ramipril			Low risk of bias	negative
aliskiren
ACCELERATE, 2011    NCT	aliskiren	amlodipine				-
AVOID, 2008      NCT	aliskiren	placebo			Low risk of bias	negative
Schmieder (vs HCTZ), 2009	aliskiren	hydrochlorothiazide			Low risk of bias	negative
ALLAY, 2009      NCT	aliskiren	losartan			Exploratory	negative
Andersen, 2008	aliskiren	ramipril			Low risk of bias	-
amlodipine
IDNT (amlodipine vs PBO), 2001	amlodipine	placebo			Low risk of bias	negative
IDNT (amlodipine vs pbo), 2001	amlodipine	placebo			Low risk of bias	negative
Tepel et al, 2008      NCT	amlodipine	placebo			Low risk of bias	negative
ASCOT-BPLA, 2005	amlodipine	atenolol			Risk of bias	suggesting
ALLHAT (amlodipine vs chlor, diabetic subgroup), 2002	amlodipine	chlorthalidone			Low risk of bias	negative
ALLHAT (CCB vs diu), 2002	amlodipine	chlorthalidone				negative
FACET, 1997	amlodipine	fosinopril			Risk of bias	suggesting
ACCOMPLISH, 2008        NCT	amlodipine plus benazepril	hydrochlorothiazide plus benazepril			Low risk of bias	suggesting
ALLHAT (CCB vs ACEI), 2002	amlodipine	lisinopril				suggesting
AASK (amlodipine vs metoprolol), 2002	amlodipine	metoprolol				negative
atenolol
Coope, 1986	atenolol	control				suggesting
Coope (subgroup ), 1986	atenolol	control			Low risk of bias	negative
MRC old (vs placebo), 1992	atenolol	placebo			Low risk of bias	negative
MRC I (vs placebo), 1985	atenolol	placebo			Low risk of bias	suggesting
Dutch TIA, 1993	atenolol	placebo			Low risk of bias	suggesting
TEST, 1995	atenolol	placebo				negative
MRC I (vs diuretics), 1985	atenolol	bendroflumethiazide			Low risk of bias	negative
MRC old (vs diuretics), 1992	atenolol	hydrochlorothiazide+amiloride			Low risk of bias	negative
candesartan
Takahashi, 2006	candesartan	control			Exploratory	negative
E-COST, 2005	candesartan	conventional treatment			Risk of bias	suggesting
E-COST-R, 2005	candesartan	conventional treatment			Risk of bias	negative
HIJ-CREATE, 2009	candesartan	conventional treatment			Risk of bias	suggesting
SCOPE, 2003	candesartan	placebo			Low risk of bias	negative
TROPHY, 2006      NCT	candesartan	placebo			Low risk of bias	suggesting
HSCS, 1974	deserpidine +methylclothiazide	placebo			Low risk of bias	negative
Takahashi et al, 2006	candesartan	usual care				suggesting
Suzuki et al, 2008	candesartan	usual care				suggesting
CASE-J, 2008	candesartan	amlodipine			Risk of bias	suggesting
ALPINE, 2003	candesartan	hydrochlorothiazide			Low risk of bias	suggesting
captopril
UKPDS 38, 1998	captopril or atenolol	control			Exploratory	suggesting
UKPDS 39, 1998	captopril	atenolol			Exploratory	negative
CAPP (diabetic subgroup), 1999	captopril	diuretic and/or beta-blockers			Exploratory	suggesting
UKPDS-HDS, 1998	captopril	diuretic or beta-blocker				negative
CAPPP, 1999	captopril	diuretic or beta-blocker			Risk of bias	negative
carvedilol
Cice et al, 2003	carvedilol	placebo				suggesting
Nakao et al, 2007	carvedilol	placebo				-
chlorthalidone
SHEP (diabetic subgroup), 1996	chlorthalidone	placebo			Low risk of bias	suggesting
VA-NHLBI, 1977	chlorthalidone	placebo				negative
SHEP, 1991      NCT	chlorthalidone	placebo			Low risk of bias	suggesting
SHEP-pilot, 1989	chlorthalidone	placebo			Low risk of bias	negative
SHEP-P (subgroup ), 1989	chlorthalidone	placebo			Low risk of bias	suggesting
SHEP (subgroup ), 1991	chlorthalidone	placebo			Low risk of bias	suggesting
diltiazem
NORDIL, 2000	diltiazem	diuretic or beta-blocker				suggesting
enalapril
ANBP2, 2003	enalapril	diuretics			Risk of bias	negative
ABCD (H), 1998	enalapril	nisoldipine			Low risk of bias	suggesting
fosinopril
Zannad et al, 2006	fosinopril	placebo			Low risk of bias	negative
hydrochlorothiazide
EWPHE (subgroup ), 1985	hydrochlorothiazide	placebo			Low risk of bias	negative
Kuramoto, 1981	hydrochlorothiazide + triamterene	placebo			Low risk of bias	negative
EWPHE, 1985	hydrochlorothiazide + triamterene	placebo			Low risk of bias	suggesting
indapamide
HYVET pilot, 2003						-
HYVET, 2008    NCT	indapamide	placebo			Low risk of bias	suggesting
PATS, 1995	indapamide	placebo			Low risk of bias	negative
HAPPY, 1987						negative
intensive blood pressure lowering strategies
ABCD target (H) , 2000	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes		suggesting
ABCD target (N) , 2002	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes		suggesting
irbesartan
IPDM (150mg), 2001	irbesartan	placebo			Low risk of bias	suggesting
IDNT (irbesartan vs pbo), 2001	irbesartan	placebo			Low risk of bias	suggesting
IRMA 2, 2001	irbesartan	placebo			Low risk of bias	negative
IDNT (irbesartan vs pbo), 2001	irbesartan	placebo			Low risk of bias	negative
IDNT (irbesartan vs amlodipine), 2001	irbesartan	amlodipine			Low risk of bias	suggesting
isradipine
MIDAS, 1996	isradipine	hydrochlorothiazide				negative
lacidipine
ELSA, 2002	lacidipine	atenolol			Low risk of bias	-
SHELL, 2003	lacidipine	chlorthalidone				-
lisinopril
ALLHAT (ACEI vs amlodipine), 2002	lisinopril	amlodipine			Low risk of bias	suggesting
ALLHAT (lisi vs chlor, diabetic subgroup), 2002	lisinopril	chlorthalidone			Low risk of bias	negative
ALLHAT (ACEI vs chlorthalidone), 2002	lisinopril	diuretics			Low risk of bias	negative
losartan
RENAAL, 2001	losartan	placebo			Low risk of bias	suggesting
RENAAL, 2001	losartan	placebo			Low risk of bias	-
LIFE (diabetic subgroup), 2002	losartan	atenolol			Low risk of bias	suggesting
LIFE, 2002	losartan	atenolol			Low risk of bias	suggesting
nicardipine
NICS-EH, 1999	nicardipine	trichlormethiazide			Low risk of bias	negative
nidrendipine
Syst-Eur (subgroup ), 1997	nidrendipine	placebo			Low risk of bias	negative
SYST-EUR, 1997	nitrendipine	placebo				suggesting
Syst-Eur (diabetic subgroup), 1999	nitrendipine	placebo			Low risk of bias	suggesting
nifedipine
Castel, 1994	nifedipine	atenolol+chlorthalidone				negative
INSIGHT (diabetic subgroup), 2000	nifedipine	coamilozide			Low risk of bias	negative
INSIGHT, 2000	nifedipine	hydrochlorothiazide+amiloride			Low risk of bias	suggesting
nisoldipine
ABCD (hypertension), 1998	nisoldipine	enalapril			Low risk of bias	suggesting
oxprenolol
IPPPSH, 1985	oxprenolol	placebo			Low risk of bias	negative
propranolol
Berglund, 1986	propranolol	bendroflumethiazide				negative
ramipril
Li et al, 2003	ramipril	usual care				negative
AASK (ramipril vs amlodipine), 2002	ramipril	amlodipine			Low risk of bias	negative
AASK (ramipril vs metoprolol), 2002	ramipril	metoprolol			Low risk of bias	negative
telmisartan
PROPHESS, 2008      NCT	telmisartan	placebo			Low risk of bias	negative
Cice et al, 2006	telmisartan	placebo				suggesting
thiazid diuretic
ANBPS (Australian ), 1980	thiazide diuretics	control			Low risk of bias	negative
Oslo (Hegeland), 1980	thiazide diuretics	control				negative
Carter, 1970	thiazide diuretics	control				suggesting
MCR 35-64 (diuretics vs pbo), 1985	thiazide diuretics	placebo				suggesting
various ACEI
STOP-2 (ACEI vs felodipine or isradipine), 1999	various ACEI	calcium-channel blocker				suggesting
STOP 2 (ACEI vs diurectic or beta-blocker), 1999	various ACEI	diuretic or beta-blocker				suggesting
JMIC-B, 2002	various ACEI	nifedipine				-
various beta blockers
STOP, 1991	various beta-blockers	placebo			Low risk of bias	suggesting
HAPPHY, 1988	various beta-blockers	diuretics				negative
Yurenev, 1992	various beta-blockers	diuretics				negative
various diuretics
HDFP, 1979    NCT	High-dose diuretics	control				suggesting
VA-I, 1967	High-dose diuretics	placebo				suggesting
VA II, 1970	High-dose diuretics	placebo				suggesting
Barraclough, 1973	High-dose diuretics	placebo				negative
MRC (diu vs BB), 1985	High-dose diuretics	beta-blockers				-
verapamil
INVEST (Pepine), 2003      NCT	verapamil	atenolol				negative
VHAS, 1998	verapamil	chlorthalidone				negative
CONVINCE, 2003	verapamil	diuretic or beta-blocker			Low risk of bias	negative
antiplatelets drug
aspirin
HOT, 1998	aspirin	placebo	primary prevention		Low risk of bias	suggesting
cholesterol lowering intervention
atorvastatin
ASCOT, 2003	atorvastatin	placebo	at risk hypertensive	hypertensive patients	Low risk of bias	conclusive
fluvastatin
HYRIM, 2005	fluvastatin	placebo	hypertensive	hypertensive patients	Exploratory	negative
intensive blood pressure control
intensive blood pressure lowering strategies
SPRINT, 2015      NCT	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie	test é		Risk of bias	suggesting
UKPDS-HDS, 1998	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes	Risk of bias	suggesting
JATOS, 2008	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		elderly	Risk of bias	negative
VANLISH, 2010	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		elderly	Risk of bias	negative
HOMED-BP, 2012	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie			Risk of bias	negative
SPS3, 2013      NCT	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie			Risk of bias	negative
Wei, 2013	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		elderly	Risk of bias	suggesting
PAST-BP, 2015	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie				negative
MDRD, 1994	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		nondiabetic kidney disease		suggesting
HOT, 1994	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie				negative
ABCD target (H) , 2000	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes		suggesting
AASK, 2002	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		nondiabetic kidney disease		negative
REIN-2, 2005	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		nondiabetic kidney disease		negative
ABCD target (N) , 2002	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes		suggesting
Toto, 1995	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		nondiabetic kidney disease		negative
ACCORD blood pressure, 2008        NCT	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie		type 2 diabetes	Risk of bias	suggesting
Cardio-Sis, 2009      NCT	more intensive blood pressure lowering strategie	less intensive blood pressure lowering strategie	test 1		Exploratory	suggesting
renal denervation
not classified
EnligHTN-IV    NCT	EnligHTN system	control				-
Symplicity HTN-2, 2010      NCT	Symplicity system	control				-
Symplicity HTN-3, 2014      NCT	Symplicity system	sham procedure			Low risk of bias	-
renin inhibitor
aliskiren
AVOID, 2008      NCT	aliskiren	placebo			Low risk of bias	negative
Schmieder (vs HCTZ), 2009	aliskiren	hydrochlorothiazide			Low risk of bias	negative
ALLAY, 2009      NCT	aliskiren	losartan			Exploratory	negative
Andersen, 2008	aliskiren	ramipril			Low risk of bias	-