Why the study?
To assess how much blood pressure-lowering drugs reduce BP in heart failure, evaluate associations with cause-specific outcomes, and determine if treatment effects vary by baseline BP.
Do drugs with blood pressure-lowering properties reduce blood pressure and improve outcomes in patients with chronic heart failure regardless of baseline blood pressure?
Do drugs with blood pressure-lowering properties reduce blood pressure and improve outcomes in patients with chronic heart failure regardless of baseline blood pressure?
Blood pressure-lowering drugs provide a small but significant reduction in systolic blood pressure in heart failure patients, with consistent efficacy and safety regardless of baseline blood pressure.
: We aimed to combine evidence from all heart failure trials that have investigated the effects of drugs with blood pressure (BP)-lowering properties to assess the extent to which such drugs reduce BP in heart failure, the association between the net change in BP between treatment arms and cause-specific outcomes and whether treatment effects (efficacy and safety) vary according to baseline BP. We conducted a systematic review and meta-analysis including randomized clinical trials of drugs with BP-lowering properties in patients with chronic heart failure with at least 300 patient-years follow-up. We included a total of 37 trials (91 950 patients) and showed that treatment with drugs with BP-lowering properties resulted in a small but significant decrease in SBP in patients with heart failure with no evidence that the efficacy and safety of those drugs varied according to baseline BP.
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Pinho‐Gomes et al. (2019) studied this question.
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