scholarly journals Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yara Wanas ◽  
Rim Bashir ◽  
Nazmul Islam ◽  
Luis Furuya-Kanamori
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Angiotensin Receptor ◽  
Randomized Controlled ◽  
Major Cardiovascular Events ◽  
Receptor Blockers

scholarly journals Clinical Efficacy of Jinshuibao Capsules Combined with Angiotensin Receptor Blockers in Patients with Early Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Qiang Lu ◽  
Cailan Li ◽  
Weiwen Chen ◽  
Zhongfeng Shi ◽  
Ruoting Zhan ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Randomized Controlled Trials ◽  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Angiotensin Receptor ◽  
Randomized Controlled ◽  
Specific Effects ◽  
Receptor Blockers ◽  
Early Diabetic Nephropathy

Background. Jinshuibao capsules (JSB) have been widely used to treat early diabetic nephropathy (DN), but the specific effects are still inconsistent. A meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the clinical efficacy of JSB for early DN. Methods. Four international databases and four Chinese databases were searched from publication dates to March 1, 2018. The RCTs reporting the results of JSB’s specific effects were included, and comparisons were between JSB combined with Angiotensin Receptor Blockers (ARBs) as experimental intervention and ARBs as the control. Included studies’ quality was evaluated and the extracted data were analyzed with RevMan 5.3 software. Results. Twenty-six RCTs including 2198 early DN participants were adopted in the meta-analysis. The results showed that, compared with the ARBs alone, JSB could remarkably improve the ORR (OR = 3.84; 95% CI: 2.37~6.24; P<0.00001) and decrease 24 h UTP (MD = −93.32; 95% CI: −128.60 ~-58.04; P<0.00001), UAER (MD = −24.02; 95% CI: −30.93 ~-17.11; P<0.00001), BUN (MD = −0.26; 95%: −0.44 ~-0.08; P=0.005), Scr (MD = −9.07; 95% CI: −14.26 ~-3.88; P=0.0006), ACR (MD = −17.55; 95% CI: −22.81 ~-12.29; P<0.00001), Cys-C (MD = −0.60; 95% CI: −0.88 ~-0.32; P<0.00001), SBP (MD = −3.08; 95% CI: −4.65 ~-1.52; P=0.0001), DBP (MD = −2.09; 95% CI: −4.00 ~-0.19; P=0.03), and TG (MD = −0.36; 95% CI: −0.50 ~-0.21; P<0.00001). However, it showed no significant differences in TC (MD = −0.32; 95% CI: −0.69~0.04; P=0.08), FBG (MD = 0.04; 95% CI: −0.39~0.47; P=0.87), HbA1c (MD = −0.26; 95% CI: −0.59~0.06; P=0.11), and β2-MG (MD = −15.61; 95% CI: −32.95~1.73; P=0.08). Conclusions. This study indicates that JSB is an effective accessory therapeutic medicine for patients with early DN. It contributes to decreasing blood pressure and the content of triglyceride and improving the renal function of early DN patients. However, there is still a need to further verify the auxiliary therapeutic effect of JSB with more strictly designed RCTs with large sample and multiple centers in the future.

scholarly journals Penerapan DASH (Dietary Approach to Stop Hypertension) pada Penderita Hipertensi

2019 ◽  
Vol 14 (2) ◽  
pp. 17-22
Author(s):  
Bagas Mukti
Keyword(s):  
Calcium Channel ◽  
Randomized Controlled Trials ◽  
Ace Inhibitor ◽  
Channel Blocker ◽  
Angiotensin Receptor Blockers ◽  
Controlled Trials ◽  
Angiotensin Receptor ◽  
Randomized Controlled ◽  
Receptor Blockers ◽  
Β Blocker

Hipertensi merupakan suatu manifestasi dari gangguan hemodinamik kardiovaskular yang penyebabnya multifactor. Prevalensi penderita hipertensi di Indonesia sendiri pada tahun 2018 meningkatkan dari tahun 2013 dan peningkatan tersebut sebesar 8,3 %. Seseorang dikatakan hipertensi jika tekanan darah diatas atau sama dengan 140/90 mmHg dan harus persisten. Hipertensi sendiri masih menjadi penyebab kematian tertinggi dan dapat menyebabkan komplikasi yang serius seperti stroke, penyakit jantung iskemik, gagal ginjal, retinopati dan sebagainya. Ada banyak guidelines yang menjelaskan bagaimana manajemen terapi untuk mengurangi tekanan darah tinggi. Ada dua cara untuk mentatalaksana penderita hipertensi, yaitu dengan terapi farmakologis (Diuretik, β-blocker, ACE Inhibitor, Angiotensin Receptor Blockers (ARB), Calcium-channel blocker (CCB) dan sebagainya) dan terapi non farmakologi dengan memodifikasi gaya hidup seperti olahraga teratur, mengurangi konsumsi alcohol, menghentikan rokok, serta menurunkan berat badan, mengurangi konsumsi garam dengan cara mengadaptasi diet DASH (Dietary Approaches to Stop Hypertension). Diet DASH menerapkan pola makan yang kaya akan sayuran, buah-buahan, susu dan produk-produk susu tanpa lemak atau rendah lemak, biji-bijian, ikan, unggas, kacang-kacangan dan diet ini juga mengandung sedikit natrium, makanan manis, gula, lemak, dan daging merah. Pada penelitian meta-analisis dan sistematik review dari randomized controlled trials (RCTs), mengungkapkan bahwa penerapan diet DASH pada pasien hipertensi dapat menurunkan tekanan darah sistolik sebesar 6,74 mmHg dan tekanan darah diastolic sebesar 3,54 mmHg. Studi meta-analisis lain dari RCTs membuktikan bahwa dengan penerapan diet ini dapat menurunkan berat badan pada pasien yang mengalami obesitas sebesar 1,42 kg dalam waktu 8-24 minggu. Sehingga diet DASH ini sangat bermanfaat untuk diterapkan pada pasien hipertensi.

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