Khan Qaisar Ali, Sharma Shalini, Mulk Ittehad Ul, Li David, Belay Naod F, Afzal Muhammad, Farrukh Ameer Mustafa, Asad Muhammad, Baqi Abdul, Semakieh Bader
Khyber Teaching Hospital, MTI KTH.
Texas A&M School of Medicine, Bryan, TX.
Ann Med Surg (Lond). 2023 Dec 8;86(2):958-967. doi: 10.1097/MS9.0000000000001547. eCollection 2024 Feb.
Hypertension has significantly contributed to morbidity and mortality, necessitating effective management. Angiotensin receptor blockers (ARBs) have emerged as a cornerstone in hypertension treatment. Azilsartan, a relatively recent addition to the ARB family, offers unique characteristics, including prodrug activation. This systematic review and meta-analysis aimed to evaluate Azilsartan's role in reducing clinical blood pressure compared to other ARBs and determine the most effective dosage.
Following PRISMA guidelines, a comprehensive literature search was conducted in Medline, Web of Science, Cochrane Library, and clinicaltrials.gov. Eligible studies included adult hypertensive patients receiving Azilsartan compared to other ARBs, with clinical systolic blood pressure (SBP) and diastolic blood pressure (DBP) outcomes. Data extraction and quality assessment were performed, and statistical analysis employed comprehensive meta-analysis (CMA) software.
Eleven randomized controlled trials encompassing 18 studies involving 6024 patients were included. Azilsartan demonstrated significant reductions in clinical SBP (mean difference=-2.85 mmHg) and DBP (mean difference=-2.095 mmHg) compared to other ARBs. Higher doses of Azilsartan showed greater efficacy, with 80 mg exhibiting the most substantial reduction in SBP. The analysis emphasized the need for more studies investigating lower Azilsartan doses (10 and 20 mg).
This systematic review and meta-analysis underscore Azilsartan's effectiveness in reducing SBP and DBP. Dose-dependent effects emphasize the importance of optimal dosing when prescribing Azilsartan. These findings provide valuable insights for clinicians in managing hypertension effectively and call for further research, primarily focusing on lower Azilsartan doses and a more diverse patient population.
高血压对发病率和死亡率有显著影响，因此需要有效的管理。血管紧张素受体阻滞剂（ARB）已成为高血压治疗的基石。阿齐沙坦是ARB家族中较新的成员，具有独特的特性，包括前药激活。本系统评价和荟萃分析旨在评估阿齐沙坦与其他ARB相比在降低临床血压方面的作用，并确定最有效的剂量。
按照PRISMA指南，在Medline、科学网、Cochrane图书馆和clinicaltrials.gov上进行了全面的文献检索。符合条件的研究包括接受阿齐沙坦治疗的成年高血压患者与其他ARB进行比较，以临床收缩压（SBP）和舒张压（DBP）为观察指标。进行了数据提取和质量评估，并使用综合荟萃分析（CMA）软件进行统计分析。
纳入了11项随机对照试验，涵盖18项研究，涉及6024例患者。与其他ARB相比，阿齐沙坦在临床SBP（平均差值=-2.85mmHg）和DBP（平均差值=-2.095mmHg）方面有显著降低。较高剂量的阿齐沙坦显示出更大的疗效，80mg剂量的阿齐沙坦在降低SBP方面效果最为显著。分析强调需要更多研究来调查较低剂量（10mg和20mg）的阿齐沙坦。
本系统评价和荟萃分析强调了阿齐沙坦在降低SBP和DBP方面的有效性。剂量依赖性效应强调了在开具阿齐沙坦处方时优化剂量的重要性。这些发现为临床医生有效管理高血压提供了有价值的见解，并呼吁进一步开展研究，主要关注较低剂量的阿齐沙坦和更多样化的患者群体。
