Triple therapy combining ARBs, amlodipine, and rosuvastatin significantly reduced systolic blood pressure by 4.06 mmHg vs ARBs/amlodipine and by 12.28 mmHg vs ARBs/rosuvastatin, and lowered LDL cholesterol by 50.10 mg/dL vs ARBs/amlodipine after 8 weeks in patients with hypertension and dyslipidemia.
Meta-Analysis (n=1,074)
Sí
Does triple therapy with ARBs, amlodipine, and rosuvastatin improve blood pressure and lipid profiles in patients with hypertension and dyslipidemia compared to dual therapy?
Triple combination therapy with ARBs, amlodipine, and rosuvastatin significantly improves blood pressure and lipid profiles compared to dual therapies in patients with hypertension and dyslipidemia, with a comparable safety profile.
Estimación del efecto: Compared with ARBs/amlodipine: mSBP MD -4.06 mmHg (95% CI -7.97 to -0.15, p=0.04), mDBP MD -5.45 mmHg (95% CI -7.96 to -2.93, p<0.0001), LDL-C MD -50.10 mg/dL (95% CI -55.55 to -44.64, p<0.00001); Compared with ARBs/rosuvastatin: mSBP MD -12.28 mmHg (95% CI -16.68 to -7.88, p<0.00001), mDBP MD -6.48 mmHg (95% CI -10.95 to -2.01, p=0.005), LDL-C MD -2.07 mg/dL (95% CI -5.17 to 1.04, p=0.19) (95% CI See effect_size)
valor p: p=See effect_size
Abstract Background Hypertension (HTN) and dyslipidemia are major risk factors for cardiovascular diseases. Recently, researchers have investigated the potential benefits of combining multiple medications in one bill to improve their metabolic and cardiovascular efficacy. Objectives We investigated a treatment approach that combines two antihypertensive medications with one statin. We aim to assess the safety and effectiveness of a triple therapy regimen consisting of angiotensin receptor blockers (ARBs) combined with amlodipine/rosuvastatin. We compared this triple therapy to dual therapy involving either ARBs/amlodipine or ARBs/rosuvastatin in patients with HTN and dyslipidemia. Methods We conducted systematic search in the following databases: Medline, Web of Science, Scopus, and Cochrane Library until August 2024. The main outcomes assessed were the variations in mean systolic blood pressure (mSBP), mean diastolic blood pressure (mDBP), and the percentage changes in LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) following an eight-week treatment period. Results Our analysis included seven randomized controlled trials (RCTs) which enrolled 1074 patients. Triple therapy revealed a significant reduction in mSBP (mean difference (MD): -4.06, 95% C.I. -7.97: -0.15, p-value = 0.04), mDBP (MD: -5.45, 95% C.I. -7.96: -2.93, p-value = < 0.0001), and LDL-C (MD: -50.10, 95% C.I. -55.55: -44.64, p-value = < 0.001) compared to ARBs/amlodipine. Triple therapy significantly decreased mSBP (MD: −12.28, 95% C.I. − 16.68: −7.88, p-value = < 0.001) and mDBP levels (MD: −6.48, 95% C.I. -10.95: -2.01, p-value = 0.005) compared with ARBs plus rosuvastatin. There was no significant difference in secondary outcomes, including total adverse events, cerebrovascular adverse events, and adverse drug reactions. Conclusion Triple therapy has greater effectiveness in decreasing blood pressure in hypertensive patients with dyslipidemia compared to treatments involving ARBs combined with amlodipine or ARBs with rosuvastatin. Additionally, Triple therapy significantly improved lipid profiles compared to the ARB/amlodipine group. Our study lays the groundwork for developing a single-pill, triple-combination therapy. Further RCTs are necessary to confirm our findings.
Shaban et al. (Mon,) conducted a meta-analysis in Patients with hypertension and dyslipidemia (n=1,074). Triple therapy (ARBs/amlodipine plus rosuvastatin) vs. Dual therapy (either ARBs/amlodipine or ARBs/rosuvastatin) was evaluated on Change in mean systolic blood pressure (mSBP), mean diastolic blood pressure (mDBP), and LDL cholesterol (LDL-C) after 8 weeks (Compared with ARBs/amlodipine: mSBP MD -4.06 mmHg (95% CI -7.97 to -0.15, p=0.04), mDBP MD -5.45 mmHg (95% CI -7.96 to -2.93, p<0.0001), LDL-C MD -50.10 mg/dL (95% CI -55.55 to -44.64, p<0.00001); Compared with ARBs/rosuvastatin: mSBP MD -12.28 mmHg (95% CI -16.68 to -7.88, p<0.00001), mDBP MD -6.48 mmHg (95% CI -10.95 to -2.01, p=0.005), LDL-C MD -2.07 mg/dL (95% CI -5.17 to 1.04, p=0.19), 95% CI See effect_size, p=See effect_size). Triple therapy combining ARBs, amlodipine, and rosuvastatin significantly reduced systolic blood pressure by 4.06 mmHg vs ARBs/amlodipine and by 12.28 mmHg vs ARBs/rosuvastatin, and lowered LDL cholesterol by 50.10 mg/dL vs ARBs/amlodipine after 8 weeks in patients with hypertension and dyslipidemia.
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