scholarly journals Effects of Major Antihypertensive Drug Classes on Erectile Function: a Network Meta-analysis

2021 ◽  
Author(s):  
Ioannis T. Farmakis ◽  
Nikolaos Pyrgidis ◽  
Ioannis Doundoulakis ◽  
Ioannis Mykoniatis ◽  
Evangelos Akrivos ◽  
...  
Keyword(s):  
Antihypertensive Drug ◽  
Erectile Function ◽  
Meta Analysis ◽  
Drug Classes

scholarly journals Comparative efficacy and acceptability of different antihypertensive drug classes for cardiovascular disease prevention: protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044302
Author(s):  
Heidi Jussil ◽  
Anna Chaimani ◽  
Bo Carlberg ◽  
Mattias Brunström
Keyword(s):  
Systematic Review ◽  
Antihypertensive Drug ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Major Adverse Cardiovascular Events ◽  
Bias Assessment ◽  
Drug Classes ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Impact

IntroductionClinical practice guidelines differ in their recommendations on first-line antihypertensive drug classes. No adequately powered randomised controlled trial have assessed all major drug classes against each other, and previous meta-analyses have mainly relied on pairwise meta-analyses for treatment comparisons.Methods and analysisA systematic review and network meta-analysis will be carried out to assess the efficacy and acceptability of all major antihypertensive drug classes. PubMed and CENTRAL were searched on 21 February 2020 to identify randomised controlled trials with at least 1000 person-years of follow-up, assessing any antihypertensive agent against other agents or placebo. All trials fulfilling the inclusion criteria will be assessed for risk of bias using the second version of Cochrane’s risk of bias assessment tool. The study selection process, risk of bias assessment and data extraction are done by two authors in duplicate. Relative risks from individual trials will be combined in pairwise meta-analyses; in the absence of important intransitivity, random-effects network meta-analysis will be performed. The primary outcome for efficacy will be major adverse cardiovascular events, whereas the primary acceptability outcome will be treatment discontinuation for any reason. Additional outcomes include all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, heart failure and acute renal failure. The impact of differences within drug classes will be explored through alternative networks, including analysing thiazide-like and thiazide-type diuretics separately.Ethics and disseminationThis review will only process aggregated study level data and does not require ethical approval. The findings will be published in a peer-reviewed medical journal.PROSPERO registration numberCRD42020205482.

scholarly journals Effects of major antihypertensive drug classes on erectile function: a network meta-analysis

2021 ◽  
Author(s):  
Ioannis T Farmakis ◽  
Nikolaos Pyrgidis ◽  
Ioannis Doundoulakis ◽  
Ioannis Mykoniatis ◽  
Evangelos Akrivos ◽  
...  
Keyword(s):  
Erectile Function ◽  
Antihypertensive Medication ◽  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Grey Literature ◽  
Antihypertensive Agents ◽  
Cochrane Library ◽  
Drug Classes ◽  
Quantitative Synthesis ◽  
Β Blockers

Abstract Aims Major antihypertensive medication classes are suggested to exert diverse effects on erectile function (EF). Guideline recommendations suggest that thiazide diuretics and β-blockers possess the worst profile regarding erectile function (EF), while angiotensin receptor blockers and nebivolol the best profile. We aimed to determine the comparative effect of major antihypertensive classes on EF in patients with or at high risk of cardiovascular disease. Methods We performed a systematic review and frequentist network meta-analysis of randomized controlled trials assessing the effect of antihypertensive agents on EF (PROSPERO: CRD42020189529). Records were identified through search of PubMed, Cochrane Library and Scopus databases and sources of grey literature until September 2020. Results We included 25 studies (7784 patients) in the qualitative and 16 studies in the quantitative synthesis. The risk of bias was concerning or high in the majority of studies and inconsistency was also high. No significant differences in EF were demonstrated in the pairwise comparisons between major antihypertensive classes. Similarly, when placebo was set as the reference treatment group, no treatment strategy yielded significant effects on EF. In the β-blockers analysis, nebivolol contributed a beneficial effect on EF only when compared to non-vasodilatory β-blockers (OR 2.92, 95% CI 1.3–6.5) and not when compared to placebo (OR 2.87, 95% CI 0.75–11.04) or to other vasodilatory β-blockers (OR 2.15, 95% CI 0.6–7.77). Conclusion All antihypertensive medication classes seem to exert neutral or insignificant effects on EF. Further high-quality studies are needed to better explore the effects of antihypertensive medication on EF.

scholarly journals Effects of renal transplantation on erectile dysfunction: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Irham Arif Rahman ◽  
Nur Rasyid ◽  
Ponco Birowo ◽  
Widi Atmoko
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Erectile Function ◽  
Meta Analysis ◽  
Post Transplantation ◽  
Stage Renal Disease ◽  
End Stage

AbstractErectile dysfunction (ED) is a major global health burden commonly observed in patients with end-stage renal disease (ESRD). Although renal transplantation improves the problem in some patients, it persists in ≈20–50% of recipients. Studies regarding the effects of kidney transplantation on ED present contradictory findings. We performed a systematic review to summarise the effects of kidney transplantation on ED. A systematic literature search was performed across PubMed, Cochrane, and Scopus databases in April 2020. We included all prospective studies that investigated the pre and posttransplant international index of erectile function (IIEF-5) scores in recipients with ED. Data search in PubMed and Google Scholar produced 1326 articles; eight were systematically reviewed with a total of 448 subjects. Meta-analysis of IIEF-5 scores showed significant improvements between pre and post transplantation. Our findings confirm that renal transplantation improves erectile function. Furthermore, transplantation also increases testosterone level. However, the evidence is limited because of the small number of studies. Further studies are required to investigate the effects of renal transplantation on erectile function.

scholarly journals Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension

2014 ◽  
Vol 37 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Natacha Levi-Marpillat ◽  
Isabelle Macquin-Mavier ◽  
Anne-Isabelle Tropeano ◽  
Gianfranco Parati ◽  
Patrick Maison
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Antihypertensive Drug ◽  
Blood Pressure Variability ◽  
Short Term ◽  
Drug Classes

Antihypertensive Drug Classes

2019 ◽  
pp. 325-335
Author(s):  
Engi Abdel-Hady Algharably ◽  
Reinhold Kreutz
Keyword(s):  
Antihypertensive Drug ◽  
Drug Classes

Abstract 14482: Apparent Resistant Hypertension is a Marker of Risk: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Magnus O Wijkman ◽  
Marcus Malachias ◽  
Brian Claggett ◽  
Susan Cheng ◽  
Kunihiro Matsushita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Antihypertensive Drug ◽  
Resistant Hypertension ◽  
Composite Endpoint ◽  
Atherosclerosis Risk In Communities ◽  
Drug Classes ◽  
Atherosclerosis Risk ◽  
Aric Study

Introduction: Apparent resistant hypertension (ARH) is a common marker of risk in patients with established cardiovascular disease. We ascertained the prevalence and prognostic significance of ARH in patients without prior cardiovascular disease. Methods: This prospective observational cohort study included 9669 community-based participants without a history of heart failure, myocardial infarction, or stroke, who completed the Atherosclerosis Risk in Communities (ARIC) study visit 4 between 1996-1998. The definition of ARH was blood pressure (BP) above goal (traditional goal <140/90mmHg, more stringent goal <130/80mmHg) despite use of ≥3 antihypertensive drug classes, or any BP with ≥4 antihypertensive drug classes. Participants with controlled hypertension (CH), defined as BP at goal with use of 1-3 antihypertensive drug classes, constituted the reference group. The outcome was a composite endpoint of heart failure, myocardial infarction, stroke, or death. Cox regression models were adjusted for age, sex, race, BMI, heart rate, smoking, eGFR, LDL, HDL, triglycerides, glucose, and diabetes. Results: Applying the traditional BP goal, 154/9669 participants (1.6%) had ARH, and there were 2311 participants with CH (23.9%). Using the more stringent BP goal, 218/9669 participants (2.3%) had ARH, and 1523 participants (15.8 %) had CH. The median follow-up time was 19 years. Apparent resistant hypertension was associated with an increased risk for the composite endpoint (adjusted hazard ratio 1.58 [95% CI 1.32-1.90] with the traditional BP goal, and adjusted hazard ratio 1.51 [95% CI 1.28-1.79] with the more stringent BP goal). Conclusions: Apparent resistant hypertension had a low prevalence but was independently associated with adverse outcome during long term follow-up, compared to controlled hypertension and even compared to uncontrolled hypertension. This was observed for both traditional and more stringent BP goals.

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