摘要
Abstract
Objective To systematically evaluate the effectivceness and safety of combined angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker(ARB) on the reverse effect of left ventricular hypertrophy in the patients with essential hypertension. Methods By retrieving the Cochrane library, PubMed, Embase, CBM, VIP, CNKI, the included randomized controlled trails (RCTs) were conducted the quality evaluation and analyzed using RevMan 5. 1 software. Results Twelve studies were included, in which 835 patients were performed the meta analysis. The results showed that the left ventricular mass index(LVMI) in the combination therapy group was superior to the simple ARB group with statistical difference between the two groups [MD= - 14. 74,95％ CI( - 16. 71, - 12. 76), P < 0. 000 01 ]; there was significant statistical but not clinical difference for mean 24 h ambulatory blood pressure (SBP) [ MD = -2.33,95％ CI( -4.54, -0. 12), P = 0. 04]. Moreover, the incidence rate of total adverse reactions and dry cough had no statistical difference between the two groupsf RR = 1. 24, 95％ CI(0. 58, 2. 63) , P = 0. 57; RR =7. 13, 95％ CI(0. 92, 55. 54) , P = 0. 06] . Conclusion Combination of the reverse effect of ACEI and ARB combination on left ventricular hypertrophy is superior to ARB alone without increasing adverse reactions. But the included studies are not of good quality, the high quality RCT should be needed to further confirmation.关键词
血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体阻滞剂/高血压/左室肥厚/系统评价Key words
ACEI/ ARB/ hypertension/ left ventricular hypertrophy/ systematic evaluation分类
医药卫生
