Endothelin-receptor antagonist can reduce blood pressure in patients with hypertension: a meta-analysis.
The aim of this meta-analysis was to assess the effectiveness and safety of endothelin-receptor antagonist (ERA) in the patients with hypertension. Searches of the PubMed, EMBASE, and CENTRAL databases were conducted to include all the randomized control trials (RCTs). Eighteen trials including 4898 patients were used in the meta-analysis, of which nine were classified as low risk of bias and the other nine as unclear risk of bias. There was no statistically significant difference in all-cause mortality between ERA and placebo groups [6 trials, fixed effects model, RR 1.53 (0.89-2.62); random effects model, RR 1.45 (0.84-2.52)]. ERA significantly reduced 24-h ambulatory blood pressure and sitting blood pressure in patients with hypertension [5 trials, 24-h SBP: WMD -7.65 (-8.95 to -6.36), 24-h DBP: WMD -5.92 (-7.50 to -4.33); 18 trials, SBP: WMD -6.12 (-7.87 to -4.36), DBP: WMD -3.81 (-4.82 to -2.80)]. However, ERA had more adverse events [within 24 h: 3 trials, RR 1.16 (0.82-1.65); after 24 h, 13 trials, RR 1.21 (1.08-1.36)] and severe adverse events than placebo controls [SAE: 9 trials, RR 1.34 (1.13-1.60)]. In addition, there is a potential need for further RCTs that focus on the use of ERA in patients with hypertension.
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Wenming
W
Yuan
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Genyang
G
Cheng
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Bin
B
Li
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Yansheng
Y
Li
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Shan
S
Lu
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Dong
D
Liu
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Jing
J
Xiao
a Renal Division, Department of Medicine , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
Zhanzheng
Z
Zhao
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077868:Atrasentan; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D000077300:Bosentan; D065128:Endothelin Receptor Antagonists / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D015233:Models, Statistical; D010666:Phenylpropionates / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011759:Pyrrolidines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013449:Sulfonamides / Q000627:therapeutic use; D016019:Survival Analysis; D013777:Tetrazoles / Q000627:therapeutic use
D000959:Antihypertensive Agents; D065128:Endothelin Receptor Antagonists; D010666:Phenylpropionates; D011725:Pyridines; D011743:Pyrimidines; D011759:Pyrrolidines; D013449:Sulfonamides; D013777:Tetrazoles; C107831:darusentan; C120582:tezosentan; C484919:Avosentan; D000077300:Bosentan; D000077868:Atrasentan
24-hour ambulatory blood pressure; Endothelin-receptor antagonist; hypertension; meta-analysis