Re-evaluation of systematic reviews on the treatment of hypertension with angiotensinⅡ receptor antagonists
Objective To re-evaluate the systematic reviews/meta-analyses of the efficacy of five angiotensin Ⅱ receptor antagonists,including losartan,valsartan,telmisartan,candesartan,and irbesartan,in treating hypertension.Methods A sys-tematic search of Chinese National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,PubMed,Embase,and the Cochrane Library was conducted up to April 2023 for meta-analyses/systematic reviews on the use of losar-tan,valsartan,telmisartan,candesartan,and irbesartan in treating hypertension.Literature screening and data extraction were performed,and the reporting,methodology,and evidence quality were assessed using the PRISMA statement,AMSTAR-2 scale,and GRADE system.The results of the evaluation of reporting,methodology,and evidence quality were analyzed,and the findings and conclusions of the literature were descriptively analyzed.Results A total of 15 articles were included.Evalua-tion according to the PRISMA statement revealed that 9 articles had relatively complete reporting,while 6 articles had some de-ficiencies.According to the AMSTAR-2 assessment,7 studies were of low quality,7 were of very low quality,and only 1 was of high quality.Evaluation using the GRADE system showed that among the 28 included outcome indicators,6 were of high quality,13 were of moderate quality,7 were of low quality,and 2 were of very low quality.A comprehensive analysis of quantitative results for each outcome measure showed that telmisartan was superior in reducing baseline blood pressure levels and 24 hour ambulatory blood pressure levels compared to other drugs,with no significant differences in adverse reaction events.Conclusion Telmisartan demonstrates some advantages in lowering blood pressure efficacy,and there were no signifi-cant differences in the related adverse reactions among these 5 drugs.However,the quality of the studies included in this anal-ysis was generally low,indicating the need for more standardized approaches in future research.
angiotensin receptor antagonisthypertensionsystematic evaluation and re-evaluation
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