de Lemos Hernani Pinto, Atallah Alvaro Nagib, de Lemos André Luis Alves
Brazilian Cochrane Center, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
Sao Paulo Med J. 2008 Nov;126(6):342-6. doi: 10.1590/s1516-31802008000600010.
Systemic arterial hypertension is part of the metabolic syndrome resulting from obesity.
To evaluate the effect of sibutramine on overweight and obese patients' blood pressure through a systematic review.
All the studies included needed to be randomized controlled trials. The methodological quality of the selected trials was assessed using the criteria described in the Cochrane Handbook. The participants were overweight and obese patients; the intervention was sibutramine compared with placebo. The primary outcome measurement was systolic and diastolic blood pressure and the secondary measurement was blood pressure. Studies were identified by searching the following sources: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medline, Cochrane reviews, manual searches, personal communication and contact with the pharmaceutical industry. There were no language, date or other restrictions. Data collection and extraction was performed by two reviewers, who independently obtained the full articles of all eligible papers.
Three meta-analyses were produced: 1) systolic blood pressure outcome (eight studies) did not show statistical significance between sibutramine and placebo: weighted mean difference (WMD) 1.57, confidence interval (CI) -0.03 to 3.18; 2) diastolic blood pressure outcome (ten studies) did not show statistical significance between sibutramine and placebo: WMD 1.13, CI -0.49 to 2.76; 3) blood pressure outcome (two studies) also did not show statistical significance between the groups: relative risk (RR) 0.69, CI 0.07 to 7.01.
The meta-analyses presented in this systematic review show that sibutramine does not have a statistically significant effect on blood pressure, compared with placebo.
系统性动脉高血压是肥胖所致代谢综合征的一部分。
通过系统评价评估西布曲明对超重和肥胖患者血压的影响。
纳入的所有研究均需为随机对照试验。采用《Cochrane手册》中描述的标准评估所选试验的方法学质量。参与者为超重和肥胖患者;干预措施为西布曲明与安慰剂对比。主要结局指标为收缩压和舒张压,次要指标为血压。通过检索以下来源确定研究:拉丁美洲及加勒比健康科学文献数据库(Lilacs)、医学文献数据库(Medline)、Cochrane系统评价、手工检索、个人交流以及与制药行业联系。无语言、日期或其他限制。由两名评价员进行数据收集和提取,他们独立获取所有符合条件论文的全文。
进行了三项荟萃分析:1)收缩压结局(八项研究)显示西布曲明与安慰剂之间无统计学显著性差异:加权均数差(WMD)为1.57,置信区间(CI)为-0.03至3.18;2)舒张压结局(十项研究)显示西布曲明与安慰剂之间无统计学显著性差异:WMD为1.13,CI为-0.49至2.76;3)血压结局(两项研究)显示两组之间也无统计学显著性差异:相对危险度(RR)为0.69,CI为0.07至7.01。
本系统评价中的荟萃分析表明,与安慰剂相比,西布曲明对血压无统计学显著影响。