title: Renin-Angiotensin System Inhibitors vs Other Antihypertensives in Hypertensive Blacks: A Meta-Analysis.
abstract: The purpose of this study was to assess the effects of renin-angiotensin system (RAS) inhibitors vs other antihypertensive agents on cardiovascular outcomes in hypertensive black patients. The authors performed a systematic review and meta-analysis of studies that compared the effects of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) with calcium channel blockers (CCBs), diuretics, and β-blockers in hypertensive black patients on cardiovascular outcomes. A total of 38,983 patients with a mean age of 60 years and mean follow-up of 4 years were included in our meta-analysis. No significant differences were found in all-cause mortality, myocardial infarction, heart failure, and cardiovascular mortality rates among patients treated with RAS inhibitors compared with CCBs, diuretics, and β-blockers. The incidence of stroke was significantly increased in patients treated with RAS inhibitors compared with CCBs (odds ratio, 1.56; 95% confidence interval, 1.31-1.87 [P<.00001]; I2=0%) and diuretics (odds ratio, 1.59; 95% confidence interval, 1.16-2.17 [P=.004]; I2=56%) but not β-blockers.
authors.affiliation: Division of the Cardiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Mohan
authors.initials: M
authors.lastname: Palla
authors.affiliation: Division of the Cardiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Tomo
authors.initials: T
authors.lastname: Ando
authors.affiliation: John Radcliffe Hospital, University of Oxford, Oxford, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Androulakis
authors.affiliation: Division of the Cardiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Telila
authors.affiliation: Division of the Cardiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Briasoulis
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044383:Black People; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects*; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics