Findings

What do systematic reviews say?

2,532 questions · 2,642 findings · 483 reviews · Headline outcomes only

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No studies found 534 · 20.2%GRADE not reported 82 · 3.1%Very low 641 · 24.3%Low 807 · 30.5%Moderate 472 · 17.9%High 106 · 4%

First‐line low‐dose thiazide vs placebo

Cardiovascular events · adults with primary hypertension

1 finding from 1 review

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

Withdrawals due to adverse events · adults with primary hypertension

1 finding from 1 review

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

Total mortality · adults with primary hypertension

1 finding from 1 review

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

Stroke · adults with primary hypertension

1 finding from 1 review

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

Total coronary heart disease · adults with primary hypertension

1 finding from 1 review

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

Cardiovascular events · adults with primary hypertension

1 finding from 1 review

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

RAS inhibitors vs CCBs

All‐cause death · patients with hypertension

RAS inhibitors showed no clear difference in all‐cause death 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 1.03 [0.98, 1.09]
5 studies · 35226 participants
Moderate

RAS inhibitors vs thiazides

Myocardial infarction · patients with hypertension

RAS inhibitors showed no clear difference in total myocardial infarction 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 0.93 [0.86, 1.01]
2 studies · 24379 participants
Moderate

RAS inhibitors vs thiazides

Stroke · patients with hypertension

RAS inhibitors probably leads to higher total stroke 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 1.14 [1.02, 1.28]
1 study · 24309 participants
Moderate

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