摘要
Abstract
OBJECTIVE: To systematically evaluate the effectiveness and security of levoamlodipine and amlodipine in the treatment of essential hypertension. METHODS: We searched Medline, Embase, Cochrane Library, CBM and CNKI, randomized controlled trials (RCT) on levoamlodipine and amlodipine in the treatment of essential hypertension were included and compared. The methodological quality of included studies was evaluated and meta-analysis was performed by RevMan 5.1 software. RESULTS: 20 RCT invdving 3 127 patieuts were included. Meta-analysis showed that both levamlodipine and amlodipine were effective in lowering blood pressure. There were no statistical differences in total efficiency[RR=1.04, 95%CI(1.00, 1.08), P=0.08], decreased value of systolic blood pressure[SMD=-0.40, 95%CI(-0.84, 0.05), P=0.08], decreased value of 24 h average systolic blood pressure[WMD=-0.18, 95%CI( -1.05, 0.68), P= 0.68], the number of doses increase[RR=0.82, 95%CI(0.64, 1.05), P=0.11]. Levoamlodipine was better than amlodipine in the effect of reducing the clinic diastolic blood pressure[SMD= - 0.43, 95%CI(-0.81, -0.06), P=0.02] and 24 h average diastolic blood pressure[WMD=-0.86, 95%C1(-1.65, -0.07), P=0.03]. Safety analysis showed the incidence of adverse drug reaction in levoamlodipine group was less than in amlodipine group[RR= 0.43, 95%CI(0.33, 0.57), P＜0.000 01=. CONCLUSIONS: According to the result of Meta-analysis, levoamlodipine is similar to amlodipine in the treatment of essential hypertension, and levoamlodipine is better than amlodipine in the effect of reducing the diastolic blood pressure with less adverse drug reaction. The reliability of systematic review is affected by low quality of included study. Further reasonable designed, multi-center and large-scale randomized controlled trials with enough following-up should be carried out to validate the therapeutic efficacy and safety.关键词
左旋氨氯地平/氨氯地平/原发性高血压/Meta分析Key words
Levoamlodipine/ Amlodipine/ Essential hypertension/ Meta-analysis分类
医药卫生
