Rivista in lingua italiana
riservata ai Soci SISA
Ultimo numero:
Anno 14 • N.4/2023
OBJECTIVE: To quantify the incremental effect of combining blood pressure-lowering drugs from any 2 classes of thiazides, beta-blockers, angiotensin-converting enzyme inhibitors, and calcium channel blockers over 1 drug alone and to compare the effects of combining drugs with doubling dose. METHODS: Meta-analysis of factorial trials in which participants were randomly allocated to 1 drug alone, another drug alone, both drugs together, or a placebo. RESULTS: We identified 42 trials (10,968 participants). With a thiazide used alone, the mean placebo-subtracted reduction in systolic blood pressure was 7.3 mm Hg and 14.6 mm Hg combined with a drug from another class. The corresponding reductions were 9.3 mm Hg and 18.9 mm Hg with a beta-blocker, 6.8 mm Hg and 13.9 mm Hg with an angiotensin-converting enzyme, and 8.4 mm Hg and 14.3 mm Hg with a calcium channel blocker. The expected blood pressure reduction from 2 drugs together, assuming an additive effect, closely predicted the observed blood pressure reductions. The ratios of the observed to expected incremental blood pressure reductions from combining each class of drug with any other over that from 1 drug were, respectively, for thiazides, beta-blockers, angiotensin-converting enzyme inhibitors, and calcium channel blockers: 1.04 (95% confidence interval [CI], 0.88-1.20), 1.00 (95% CI, 0.76-1.24), 1.16 (95% CI, 0.93-1.39), and 0.89 (95% CI, 0.69-1.09); the overall average was 1.01 (95% CI, 0.90-1.12). Comparison of our results with those of a published meta-analysis of different doses of the same drug showed that doubling the dose of 1 drug had approximately one fifth of the equivalent incremental effect (0.22 [95% CI, 0.19-0.25]). CONCLUSION: Blood pressure reduction from combining drugs from these 4 classes can be predicted on the basis of additive effects. The extra blood pressure reduction from combining drugs from 2 different classes is approximately 5 times greater than doubling the dose of 1 drug.
Modena, 22-23 Giugno 2023
[continua a leggere]Rivista in lingua italiana
riservata ai Soci SISA
Ultimo numero:
Anno 14 • N.4/2023
Rivista Italiana della
Ipercolesterolemia
Familiare Omozigote
Anno 5 • N.1/2023
Nuovo sito dedicato al Progetto LIPIGEN
Progetto LIPIGEN - Vecchio portale
E' necessario essere loggati come utente
Lipigen per poter accedere alla pagina
PROSISA – PROject Statin Intolerance SISA
E' necessario essere loggati come utente
PROSISA per poter accedere alla pagina
Gruppo Interdisciplinare Lipoprotein Aferesi
(Accesso Gruppo GILA-Lipoprotein Aferesi)
E' necessario essere loggati come utente del Gruppo GILA per poter accedere
Gruppo Interdisciplinare Lipoprotein Aferesi
(Documentazione ad accesso libero)
Pagina informativa per medici e pazienti