What do systematic reviews say?

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

RAS inhibitors vs beta‐blocker

RAS inhibitors may leads to lower total cardiovascular events 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 0.88 [0.8, 0.98]
  2 studies · 9239 participants
  Low

RAS inhibitors vs beta‐blocker

RAS inhibitors showed no clear difference in total heart failure 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 0.95 [0.76, 1.18]
  1 study · 9193 participants
  Low

RAS inhibitors vs beta‐blocker

RAS inhibitors showed no clear difference in total myocardial infarction 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 1.05 [0.86, 1.27]
  2 studies · 9239 participants
  Low

RAS inhibitors vs beta‐blocker

RAS inhibitors may leads to lower total stroke 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 0.75 [0.63, 0.88]
  1 study · 9193 participants
  Low

RAS inhibitors vs CCBs

RAS inhibitors showed no clear difference in total cardiovascular events 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 0.98 [0.93, 1.02]
  6 studies · 35223 participants
  Moderate

RAS inhibitors vs CCBs

RAS inhibitors probably leads to lower death or hospitalization for heart failure 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 0.83 [0.77, 0.9]
  5 studies · 35143 participants
  Moderate

RAS inhibitors vs CCBs

RAS inhibitors showed no clear difference in total myocardial infarction 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 1.01 [0.93, 1.09]
  5 studies · 35043 participants
  Moderate

RAS inhibitors vs CCBs

RAS inhibitors probably leads to higher total stroke 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 1.19 [1.08, 1.32]
  4 studies · 34673 participants
  Moderate

RAS inhibitors vs CCBs

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

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

RAS inhibitors vs thiazides

RAS inhibitors showed no clear difference in all‐cause death 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 [0.94, 1.07]
  1 study · 24309 participants
  Moderate

RAS inhibitors vs thiazides

RAS inhibitors showed no clear difference in total cardiovascular events 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 1.05 [1, 1.11]
  2 studies · 24379 participants
  Moderate

RAS inhibitors vs thiazides

RAS inhibitors probably leads to higher death or hospitalization for heart failure 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 1.19 [1.07, 1.31]
  1 study · 24309 participants
  Moderate

Interventions vs placebo or no prophylaxis

Interventions probably leads to lower clinically important upper GI bleeding compared with placebo or no prophylaxis (moderate certainty).

• Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units 2018 · Cochrane Headline outcomes only
  RR 0.47 [0.39, 0.57]
  30 studies · 3207 participants
  Moderate

H2 receptor antagonists vs placebo or no prophylaxis

• Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 230 participants
  Low

H2 receptor antagonists vs placebo or no prophylaxis

H2 receptor antagonists probably leads to lower number of participants requiring blood transfusions compared with placebo or no prophylaxis (moderate certainty).

• Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units 2018 · Cochrane Headline outcomes only
  RR 0.58 [0.36, 0.95]
  7 studies · 655 participants
  Moderate

H2 receptor antagonists vs placebo or no prophylaxis

The review found no eligible studies for this question.

• Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Proton pump inhibitors (PPI) vs placebo or no prophylaxis

Proton pump inhibitors showed no clear difference in clinically important upper GI bleeding compared with placebo or no prophylaxis (low certainty).

• Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units 2018 · Cochrane Headline outcomes only
  RR 0.63 [0.18, 2.22]
  3 studies · 237 participants
  Low