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February 21, 2025PLoS ONEOpen Access

CCBs and DIs outperformed BBs, ACEIs, and ARBs in stroke reduction, while combinations of ACEIs and CCBs were more effective than ACEIs or ARBs monotherapy in reducing stroke.

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Why the study?

The study aimed to compare the effectiveness of various antihypertensive drugs in preventing strokes in hypertensive patients.

Do different antihypertensive drug classes reduce stroke and mortality in hypertensive patients?

Population

487,076 patients across 88 RCTs

Comparison

Different antihypertensive drug classes vs each other or placebo

Design

Bayesian random-effects network meta-analysis of randomized controlled trials

Authors

DYDing YuJLJunxia LiYCYuan Cheng

Discussion

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Overview

Supports preferring CCBs or DIs for stroke prevention in hypertension; extends network evidence favoring ACEI+CCB combinations over monotherapy.

Structured PICO

Do different antihypertensive drug classes reduce stroke and mortality in hypertensive patients?

P
Population
487,076 patients from 88 RCTs (58 RCTs specifically focused on hypertensive subjects)
I
Intervention
Antihypertensive drug classes including ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), diuretics (DIs), beta-blockers (BBs), and combinations (ACEIs+CCBs)
C
Comparator
Placebo or active comparators (other antihypertensive drug classes)
O
Outcome
Strokehard clinical

This network meta-analysis suggests that dihydropyridine CCBs, thiazide-like diuretics, and ACEIs (especially combined with CCBs) provide superior protection against stroke and mortality in hypertensive patients.

Cite This Study

Yu et al. (2025) studied this question.

synapsesocial.com/papers/6a08537d0df715653be8a79fhttps://doi.org/10.1371/journal.pone.0313309
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative Efficacy of Antihypertensive Drugs for Primary Stroke Prevention–A Network Meta-Analysis of Randomized Controlled Trials2025
  2. 2Effect of Antihypertensive Drug Classes on Stroke Prevention: A Systematic Review and Meta-Analysis2026
  3. 3Role of Blood Pressure Management in Stroke Prevention: A Systematic Review and Network Meta-Analysis of 93 Randomized Controlled Trials2021 · 20 citations
  4. 4Untitled2004 · 89 citations
  5. 5The Effects of Calcium Channel Blockers in the Prevention of Stroke in Adults with Hypertension: A Meta-Analysis of Data from 273,543 Participants in 31 Randomized Controlled Trials2013 · 47 citations