Chen Jian-Dong, Liu Ming, Chen Xiao-hu, Yang Zhi-Jian
Nanjing Medical University, Nanjing, PR China.
Cardiology. 2015;131(2):69-79. doi: 10.1159/000375259. Epub 2015 Apr 9.
In a meta-analysis, we investigated the effects of angiotensin receptor blockers (ARBs) in comparison to placebo or other classes of antihypertensive drugs on endothelial function, which was measured by brachial flow-mediated vasodilation (FMD).
We searched for randomized controlled trials that compared ARBs with placebo or other classes of antihypertensive drugs in improving FMD. A random-effect model was used to compute pooled estimates.
In 13 trials (n = 529), ARBs were more efficacious in improving brachial FMD than placebo [pooled weighted mean change difference (WMD) 1.34%, 95% CI, 0.93-1.75%, p<0.001]. In 15 trials (n = 918), treatment with ARBs had a significant effect on brachial FMD when compared with other antihypertensive drugs (pooled WMD 0.59%, 95% CI, 0.20-0.98%, p = 0.003 with significant heterogeneity). ARBs were also more efficacious in improving brachial FMD than calcium channel blockers (CCBs; pooled WMD 1.61%, 95% CI, 0.72-2.49%, p < 0.001) but not the other classes of drugs (p ≥ 0.072).
This meta-analysis shows that ARBs improve brachial FMD, a marker of endothelial function, and that they are superior to placebo and CCBs. There was no significant difference in the effect on brachial FMD between ARBs and the other antihypertensive drugs.
在一项荟萃分析中，我们研究了血管紧张素受体阻滞剂（ARB）与安慰剂或其他类别降压药物相比，对通过肱动脉血流介导的血管舒张（FMD）测量的内皮功能的影响。
我们检索了比较ARB与安慰剂或其他类别降压药物在改善FMD方面的随机对照试验。采用随机效应模型计算合并估计值。
在13项试验（n = 529）中，ARB在改善肱动脉FMD方面比安慰剂更有效[合并加权平均变化差异（WMD）1.34%，95%CI，0.93 - 1.75%，p<0.001]。在15项试验（n = 918）中，与其他降压药物相比，ARB治疗对肱动脉FMD有显著影响（合并WMD 0.59%，95%CI，0.20 - 0.98%，p = 0.003，存在显著异质性）。ARB在改善肱动脉FMD方面也比钙通道阻滞剂（CCB）更有效（合并WMD 1.61%，95%CI，0.72 - 2.49%，p < 0.001），但与其他类别药物相比无差异（p≥0.072）。
这项荟萃分析表明，ARB可改善肱动脉FMD（一种内皮功能标志物），且优于安慰剂和CCB。ARB与其他降压药物在对肱动脉FMD的影响上无显著差异。
