Cochrane · systematic review · CD001841
First‐line drugs for hypertension
Wright, JM, Musini, VM, Gill, R · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
HypertensionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
23
current version
GRADE rated
23
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 12 · 52.2%Moderate 7 · 30.4%High 4 · 17.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
First‐line low‐dose thiazide compared to placebo for hypertension
Population: adult patients with primary hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total mortality First‐line low‐dose thiazide vs placebo | no estimate extracted | 8 studies · 19874 participants | High |
Total stroke First‐line low‐dose thiazide vs placebo | no estimate extracted | 8 studies · 19874 participants | High |
Total coronary heart disease First‐line low‐dose thiazide vs placebo | no estimate extracted | 7 studies · 19022 participants | High |
Total cardiovascular events First‐line low‐dose thiazide vs placebo | no estimate extracted | 7 studies · 19022 participants | High |
Withdrawal due to adverse effects First‐line low‐dose thiazide vs placebo | no estimate extracted | 3 studies · 8870 participants | Low Downgraded: risk of bias, inconsistency |
First‐line high‐dose thiazide compared to placebo for hypertension
Population: adult patients with primary hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total mortality First‐line high‐dose thiazide vs placebo | no estimate extracted | 11 studies · 19839 participants | Moderate Downgraded: risk of bias, imprecision |
Total stroke First‐line high‐dose thiazide vs placebo | no estimate extracted | 11 studies · 19839 participants | Moderate Downgraded: risk of bias, imprecision |
Total coronary heart disease First‐line high‐dose thiazide vs placebo | no estimate extracted | 11 studies · 19839 participants | Low Downgraded: risk of bias, imprecision |
Total cardiovascular events First‐line high‐dose thiazide vs placebo | no estimate extracted | 11 studies · 19839 participants | Moderate Downgraded: risk of bias, imprecision |
Withdrawal due to adverse effects First‐line high‐dose thiazide vs placebo | no estimate extracted | 7 studies · 15170 participants | Low Downgraded: risk of bias, imprecision |
First‐line beta‐blocker compared to placebo for hypertension
Population: adult patients with primary hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total mortality First‐line beta‐blocker vs placebo | RR 0.96 [0.86, 1.07] | 5 studies · 19313 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Total stroke First‐line beta‐blocker vs placebo | RR 0.83 [0.72, 0.97] | 5 studies · 19313 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Total coronary heart disease First‐line beta‐blocker vs placebo | RR 0.9 [0.78, 1.03] | 5 studies · 19313 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Total cardiovascular events First‐line beta‐blocker vs placebo | RR 0.89 [0.81, 0.98] | 5 studies · 19313 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Withdrawal due to adverse effects First‐line beta‐blocker vs placebo | RR 4.59 [4.11, 5.13] | 4 studies · 18565 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
First‐line angiotensin converting enzyme inhibitor compared to placebo for hypertension
Population: adult patients with primary hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total mortality First‐line angiotensin converting enzyme inhibitor vs placebo | RR 0.83 [0.72, 0.95] | 3 studies · 6002 participants | Moderate Downgraded: risk of bias, imprecision |
Total stroke First‐line angiotensin converting enzyme inhibitor vs placebo | RR 0.65 [0.52, 0.82] | 3 studies · 6002 participants | Low Downgraded: risk of bias, imprecision |
Total coronary heart disease First‐line angiotensin converting enzyme inhibitor vs placebo | RR 0.81 [0.7, 0.94] | 2 studies · 5145 participants | Moderate Downgraded: risk of bias, imprecision |
Total cardiovascular events First‐line angiotensin converting enzyme inhibitor vs placebo | RR 0.76 [0.67, 0.85] | 2 studies · 5145 participants | Moderate Downgraded: risk of bias, imprecision |
First‐line calcium channel blocker compared to placebo for hypertension
Population: adult patients with primary hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total mortality First‐line calcium channel blocker vs placebo | RR 0.86 [0.68, 1.09] | 1 study · 4695 participants | Low Downgraded: imprecision |
Total stroke First‐line calcium channel blocker vs placebo | RR 0.58 [0.41, 0.84] | 1 study · 4695 participants | Low Downgraded: imprecision |
Total coronary heart disease (CHD) First‐line calcium channel blocker vs placebo | RR 0.77 [0.55, 1.09] | 1 study · 4695 participants | Low Downgraded: imprecision |
Total cardiovascular events First‐line calcium channel blocker vs placebo | RR 0.71 [0.57, 0.87] | 1 study · 4695 participants | Low Downgraded: imprecision |