What do systematic reviews say?

First‐line angiotensin converting enzyme inhibitor vs placebo

First‐line angiotensin converting enzyme inhibitor may leads to lower total stroke compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.65 [0.52, 0.82]
  3 studies · 6002 participants
  Low

First‐line angiotensin converting enzyme inhibitor vs placebo

First‐line angiotensin converting enzyme inhibitor probably leads to lower total coronary heart disease compared with placebo (moderate certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.81 [0.7, 0.94]
  2 studies · 5145 participants
  Moderate

First‐line angiotensin converting enzyme inhibitor vs placebo

First‐line angiotensin converting enzyme inhibitor probably leads to lower total cardiovascular events compared with placebo (moderate certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.76 [0.67, 0.85]
  2 studies · 5145 participants
  Moderate

First‐line low‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  8 studies · 19874 participants
  High

First‐line calcium channel blocker vs placebo

First‐line calcium channel blocker showed no clear difference in total mortality compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.86 [0.68, 1.09]
  1 study · 4695 participants
  Low

First‐line calcium channel blocker vs placebo

First‐line calcium channel blocker may leads to lower total stroke compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.58 [0.41, 0.84]
  1 study · 4695 participants
  Low

First‐line calcium channel blocker vs placebo

First‐line calcium channel blocker showed no clear difference in total coronary heart disease (CHD) compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.77 [0.55, 1.09]
  1 study · 4695 participants
  Low

First‐line calcium channel blocker vs placebo

First‐line calcium channel blocker may leads to lower total cardiovascular events compared with placebo (low certainty).

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  RR 0.71 [0.57, 0.87]
  1 study · 4695 participants
  Low

First‐line low‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 19022 participants
  High

First‐line low‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 19022 participants
  High

First‐line low‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 8870 participants
  Low

First‐line high‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 19839 participants
  Moderate

First‐line high‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 19839 participants
  Moderate

First‐line high‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 19839 participants
  Low

First‐line high‐dose thiazide vs placebo

• First‐line drugs for hypertension 2018 · Cochrane Headline outcomes only
  no estimate extracted
  11 studies · 19839 participants
  Moderate

RAS inhibitors vs CCBs

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

• First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
  RR 1.03 [0.98, 1.09]
  5 studies · 35226 participants
  Moderate

RAS inhibitors vs thiazides

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

• First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
  RR 0.93 [0.86, 1.01]
  2 studies · 24379 participants
  Moderate

RAS inhibitors vs thiazides

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

• First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for… 2018 · Cochrane Headline outcomes only
  RR 1.14 [1.02, 1.28]
  1 study · 24309 participants
  Moderate

RAS inhibitors vs thiazides

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

• 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

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

• 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