Key result
Blood pressure-lowering treatment significantly reduced the risk of all strokes (OR 0.79), with network meta-analysis identifying diuretics, calcium channel blockers, and angiotensin II receptor blockers as the most effective first-line monotherapies.
Why the study?
The study aimed to compare the efficacy and tolerability of different blood pressure-lowering strategies for stroke prevention.
Do different blood pressure-lowering strategies reduce the risk of stroke and differ in tolerability?
Population
Patients across 93 randomized controlled trials
Comparison
Different BP-lowering strategies including single or combination antihypertensive agents vs placebos or other agents, and different BP targets
Design
Systematic review and network meta-analysis of randomized controlled trials
Follow-up
Average 3.3 years
Authors
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Supports diuretics, CCBs, and ARBs as preferred first-line monotherapies for stroke prevention; confirms class-specific efficacy via network meta-analysis.
Meta-Analysis (n=504,613)
Do different blood pressure-lowering strategies reduce the risk of stroke and differ in tolerability?
Effect estimate: OR 0.79 (95% CI 0.74-0.85)
Monotherapy using diuretics, CCBs, or ARBs, and their combinations, are effective and tolerable first-line treatments for stroke prevention.
Zhong et al. (2021) conducted a meta-analysis in Hypertension and Stroke Prevention (n=504,613). Blood pressure-lowering treatments (diuretics, CCB, ARB, ACEi, BB, and combinations) vs. Placebo or other antihypertensive agents was evaluated on Incidence of all strokes (OR 0.79, 95% CI 0.74-0.85). Blood pressure-lowering treatment significantly reduced the risk of all strokes (OR 0.79), with network meta-analysis identifying diuretics, calcium channel blockers, and angiotensin II receptor blockers as the most effective first-line monotherapies.
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