Findings

What do systematic reviews say?

383 questions · 414 findings · 46 reviews · Hypertension

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No studies found 15 · 3.6%GRADE not reported 31 · 7.5%Very low 80 · 19.3%Low 148 · 35.7%Moderate 116 · 28%High 24 · 5.8%

RAS inhibitors vs thiazides

End‐stage renal disease · patients with hypertension

RAS inhibitors showed no clear difference in end stage renal failure compared with thiazides (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.1 [0.88, 1.37]
1 study · 24309 participants
Low

RAS inhibitors vs beta‐blocker

All‐cause death · patients with hypertension

RAS inhibitors showed no clear difference in all‐cause death compared with beta‐blockers (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.89 [0.78, 1.01]
1 study · 9193 participants
Low

RAS inhibitors vs beta‐blocker

Cardiovascular events · patients with hypertension

RAS inhibitors may leads to lower total cardiovascular events compared with beta‐blockers (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.88 [0.8, 0.98]
2 studies · 9239 participants
Low

RAS inhibitors vs beta‐blocker

Heart failure · patients with hypertension

RAS inhibitors showed no clear difference in total heart failure compared with beta‐blockers (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.95 [0.76, 1.18]
1 study · 9193 participants
Low

RAS inhibitors vs beta‐blocker

Myocardial infarction · patients with hypertension

RAS inhibitors showed no clear difference in total myocardial infarction compared with beta‐blockers (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.05 [0.86, 1.27]
2 studies · 9239 participants
Low

RAS inhibitors vs beta‐blocker

Stroke · patients with hypertension

RAS inhibitors may leads to lower total stroke compared with beta‐blockers (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.75 [0.63, 0.88]
1 study · 9193 participants
Low

RAS inhibitors vs CCBs

Cardiovascular events · patients with hypertension

RAS inhibitors showed no clear difference in total cardiovascular events compared with CCBs (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.98 [0.93, 1.02]
6 studies · 35223 participants
Moderate

RAS inhibitors vs CCBs

Death or hospitalization for heart failure · patients with hypertension

RAS inhibitors probably leads to lower death or hospitalization for heart failure compared with CCBs (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.83 [0.77, 0.9]
5 studies · 35143 participants
Moderate

RAS inhibitors vs CCBs

Myocardial infarction · patients with hypertension

RAS inhibitors showed no clear difference in total myocardial infarction compared with CCBs (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.01 [0.93, 1.09]
5 studies · 35043 participants
Moderate

RAS inhibitors vs CCBs

Stroke · patients with hypertension

RAS inhibitors probably leads to higher total stroke compared with CCBs (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.19 [1.08, 1.32]
4 studies · 34673 participants
Moderate

RAS inhibitors vs CCBs

End‐stage renal disease · patients with hypertension

RAS inhibitors showed no clear difference in end stage renal failure compared with CCBs (low certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 0.88 [0.74, 1.05]
4 studies · 19551 participants
Low

RAS inhibitors vs thiazides

All‐cause death · patients with hypertension

RAS inhibitors showed no clear difference in all‐cause death compared with thiazides (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1 [0.94, 1.07]
1 study · 24309 participants
Moderate

RAS inhibitors vs thiazides

Cardiovascular events · patients with hypertension

RAS inhibitors showed no clear difference in total cardiovascular events compared with thiazides (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.05 [1, 1.11]
2 studies · 24379 participants
Moderate

RAS inhibitors vs thiazides

Death or hospitalization for heart failure · patients with hypertension

RAS inhibitors probably leads to higher death or hospitalization for heart failure compared with thiazides (moderate certainty).

1 finding from 1 review

First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
RR 1.19 [1.07, 1.31]
1 study · 24309 participants
Moderate

Acupuncture vs sham

Change in SBP shortly after last session · people with primary hypertension

1 finding from 1 review

Acupuncture for hypertension 2018 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 386 participants
Very low

Acupuncture vs sham

Change in DBP shortly after last session · people with primary hypertension

1 finding from 1 review

Acupuncture for hypertension 2018 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 386 participants
Very low

Intervention not reported

Adverse events · people with primary hypertension

1 finding from 1 review

Acupuncture for hypertension 2018 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 426 participants
Low

Beta‐blockers vs renin‐angiotensin system inhibitors

Total mortality

Beta‐blockers showed no clear difference in total mortality compared with renin‐angiotensin system inhibitors (moderate certainty).

1 finding from 1 review

Beta‐blockers for hypertension 2017 · Cochrane Headline outcomes only
RR 1.1 [0.98, 1.24]
3 studies · 10828 participants
Moderate

Beta‐blockers vs renin‐angiotensin system inhibitors

Total cardiovascular disease

Beta‐blockers showed no clear difference in total cardiovascular disease compared with renin‐angiotensin system inhibitors (low certainty).

1 finding from 1 review

Beta‐blockers for hypertension 2017 · Cochrane Headline outcomes only
RR 1 [0.72, 1.38]
3 studies · 10828 participants
Low

Beta‐blockers vs renin‐angiotensin system inhibitors

Stroke

Beta‐blockers probably leads to higher total stroke compared with renin‐angiotensin system inhibitors (moderate certainty).

1 finding from 1 review

Beta‐blockers for hypertension 2017 · Cochrane Headline outcomes only
RR 1.3 [1.11, 1.53]
2 studies · 9951 participants
Moderate