Key result
Allopurinol treatment did not significantly change pulse wave velocity (WMD -0.19 m/s; 95% CI -0.49 to 0.12; p=0.23) but significantly reduced augmentation index (SMD -0.34; p=0.0008).
Why the study?
Does allopurinol treatment improve arterial stiffness as measured by pulse wave velocity and augmentation index?
Meta-Analysis
Does allopurinol treatment improve arterial stiffness as measured by pulse wave velocity and augmentation index?
Mean Difference: -0.19 (95% CI -0.49–0.12)
p-value: p=0.23
Allopurinol treatment significantly reduces augmentation index but does not significantly affect pulse wave velocity, suggesting a potential but mixed benefit on arterial stiffness.
Allopurinol modestly lowers AIx but not PWV; leaves open net effects on arterial stiffness, requiring larger RCTs before clinical consideration.
BACKGROUND Several studies have tested the effects of allopurinol on arterial stiffness, but the results have been inconclusive. We aimed to conduct a meta-analysis to investigate the impacts of allopurinol treatment on arterial stiffness, as measured by pulse wave velocity (PWV) and augmentation index (AIx). MATERIAL AND METHODS Randomized controlled trials (RCTs) assessing the effects of allopurinol on arterial stiffness were identified through searching PubMed, Web of Science, EMBASE, the Cochrane Library for Central Register of Clinical Trials, and China National Knowledge Infrastructure up to December 2015. The primary endpoints were the change of PWV and AIx after allopurinol treatment. The weighted mean difference (WMD) or standardized mean difference (SMD) and the 95% confidence interval (CI) of each study were pooled for meta-analysis. RESULTS A total of 11 RCTs met the inclusion criteria and were included in the final meta-analysis. Eight RCTs with 1,111 patients were pooled for PWV; eight RCTs with 397 patients were pooled for PWV. Allopurinol administration did not significantly change PWV (WMD=-0.19 m/s, 95% CI: -0.49 to 0.12, Z=1.21, p=0.23), but significantly reduced AIx (SMD=-0.34, 95% CI: -0.54 to -0.14, Z=3.35, p=0.0008). CONCLUSIONS Although our meta-analysis showed some favorable effects of allopurinol treatment on improving AIx, its impact on arterial stiffness must be tested in more large-scale RCTs.
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Deng et al. (2016) conducted a meta-analysis in Arterial stiffness. Allopurinol vs. Control was evaluated on Change of pulse wave velocity (PWV) and augmentation index (AIx) (WMD -0.19, 95% CI -0.49 to 0.12, p=0.23). Allopurinol treatment did not significantly change pulse wave velocity (WMD -0.19 m/s; 95% CI -0.49 to 0.12; p=0.23) but significantly reduced augmentation index (SMD -0.34; p=0.0008).
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