沙库巴曲缬沙坦与奥美沙坦治疗高血压的比较：一项随机对照试验的荟萃分析。

Comparison of sacubitril/valsartan with olmesartan for hypertension: A meta-analysis of randomized controlled trials.

机构信息

School of Nursing, Beijing University of Chinese Medicine, Beijing, China.

University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, HI.

出版信息

Medicine (Baltimore). 2024 Apr 5;103(14):e37501. doi: 10.1097/MD.0000000000037501.

DOI:10.1097/MD.0000000000037501

PMID:38579097

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10994445/

Abstract

INTRODUCTION

The efficacy of sacubitril/valsartan versus olmesartan remains controversial for the control of hypertension. We conduct a systematic review and meta-analysis to explore the influence of sacubitril/valsartan versus olmesartan on the control of hypertension.

METHODS

We have searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through July 2023 for randomized controlled trials assessing the effect of sacubitril/valsartan versus olmesartan on the control of hypertension. This meta-analysis is performed using the random-effect model or fixed-effect model based on the heterogeneity.

RESULTS

Seven randomized controlled trials and 3677 patients were included in the meta-analysis. Overall, compared with olmesartan treatment for hypertension, sacubitril/valsartan treatment was associated with substantially decreased systolic blood pressure (mean difference [MD] = -4.58; 95% confidence interval [CI] = -7.90 to -1.25; P = .007), diastolic blood pressure (MD = -1.70; 95% CI = -3.24 to -0.17; P = .03), and pulse pressure (MD = -2.31; 95% CI = -4.41 to -0.21; P = .03), as well as improved systolic blood pressure control (odds ratio [OR] = 1.65; 95% CI = 1.15 to 2.38; P = .006), but had no influence on diastolic blood pressure control (OR = 1.33; 95% CI = 0.93 to 1.88; P = .11) or adverse events (OR = 1.06; 95% CI = 0.90 to 1.24; P = .51).

CONCLUSIONS

Sacubitril/valsartan is better than olmesartan for the reduction of blood pressure for patients with hypertension.

摘要

简介

沙库巴曲缬沙坦在高血压控制方面的疗效优于奥美沙坦仍存在争议。我们进行了一项系统评价和荟萃分析，以探讨沙库巴曲缬沙坦与奥美沙坦对高血压控制的影响。

方法

我们通过 2023 年 7 月之前检索 PubMed、Embase、Web of science、EBSCO 和 Cochrane 图书馆数据库，评估了沙库巴曲缬沙坦与奥美沙坦对高血压控制效果的随机对照试验。本荟萃分析基于异质性采用随机效应模型或固定效应模型进行。

结果

纳入了 7 项随机对照试验和 3677 例患者。总体而言，与奥美沙坦治疗高血压相比，沙库巴曲缬沙坦治疗与收缩压显著降低（平均差 [MD]=-4.58；95%置信区间 [CI]：-7.90 至-1.25；P=0.007）、舒张压（MD=-1.70；95%CI：-3.24 至-0.17；P=0.03）和脉压（MD=-2.31；95%CI：-4.41 至-0.21；P=0.03）相关，同时改善了收缩压控制（比值比 [OR]=1.65；95%CI：1.15 至 2.38；P=0.006），但对舒张压控制（OR=1.33；95%CI：0.93 至 1.88；P=0.11）或不良事件（OR=1.06；95%CI：0.90 至 1.24；P=0.51）没有影响。