Cochrane · systematic review · CD008170
First‐line drugs inhibiting the renin angiotensin system versus other first‐line antihypertensive drug classes for hypertension
Chen, YJ, Li, LJ, Tang, WL, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
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
17
current version
GRADE rated
17
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 7 · 41.2%Moderate 10 · 58.8%High 0 · 0%
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
Current version onlyRAS inhibitors compared to CCBs for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause death RAS inhibitors vs CCBs | RR 1.03 [0.98, 1.09] | 5 studies · 35226 participants | Moderate Downgraded: risk of bias |
Total cardiovascular events RAS inhibitors vs CCBs | RR 0.98 [0.93, 1.02] | 6 studies · 35223 participants | Moderate Downgraded: risk of bias |
Death or hospitalization for heart failure RAS inhibitors vs CCBs | RR 0.83 [0.77, 0.9] | 5 studies · 35143 participants | Moderate Downgraded: risk of bias |
Total myocardial infarction RAS inhibitors vs CCBs | RR 1.01 [0.93, 1.09] | 5 studies · 35043 participants | Moderate Downgraded: risk of bias |
Total stroke RAS inhibitors vs CCBs | RR 1.19 [1.08, 1.32] | 4 studies · 34673 participants | Moderate Downgraded: risk of bias |
End stage renal failure RAS inhibitors vs CCBs | RR 0.88 [0.74, 1.05] | 4 studies · 19551 participants | Low Downgraded: risk of bias, imprecision |
RAS inhibitors compared to thiazides for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause death RAS inhibitors vs thiazides | RR 1 [0.94, 1.07] | 1 study · 24309 participants | Moderate |
Total cardiovascular events RAS inhibitors vs thiazides | RR 1.05 [1, 1.11] | 2 studies · 24379 participants | Moderate |
Death or hospitalization for heart failure RAS inhibitors vs thiazides | RR 1.19 [1.07, 1.31] | 1 study · 24309 participants | Moderate |
Total myocardial infarction RAS inhibitors vs thiazides | RR 0.93 [0.86, 1.01] | 2 studies · 24379 participants | Moderate |
Total stroke RAS inhibitors vs thiazides | RR 1.14 [1.02, 1.28] | 1 study · 24309 participants | Moderate |
End stage renal failure RAS inhibitors vs thiazides | RR 1.1 [0.88, 1.37] | 1 study · 24309 participants | Low Downgraded: imprecision |
RAS inhibitors compared to beta‐blockers for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause death RAS inhibitors vs beta‐blockers | RR 0.89 [0.78, 1.01] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |
Total cardiovascular events RAS inhibitors vs beta‐blockers | RR 0.88 [0.8, 0.98] | 2 studies · 9239 participants | Low Downgraded: risk of bias, imprecision |
Total heart failure RAS inhibitors vs beta‐blockers | RR 0.95 [0.76, 1.18] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |
Total myocardial infarction RAS inhibitors vs beta‐blockers | RR 1.05 [0.86, 1.27] | 2 studies · 9239 participants | Low Downgraded: risk of bias, imprecision |
Total stroke RAS inhibitors vs beta‐blockers | RR 0.75 [0.63, 0.88] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |
RAS inhibitors compared to CCBs for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause death RAS inhibitors vs CCBs | RR 1.03 [0.98, 1.09] | 5 studies · 35226 participants | Moderate Downgraded: risk of bias |
Total cardiovascular events RAS inhibitors vs CCBs | RR 0.98 [0.93, 1.02] | 6 studies · 35223 participants | Moderate Downgraded: risk of bias |
Total heart failure RAS inhibitors vs CCBs | RR 0.83 [0.77, 0.9] | 5 studies · 35143 participants | Moderate Downgraded: risk of bias |
Total myocardial infarction RAS inhibitors vs CCBs | RR 1.01 [0.93, 1.09] | 5 studies · 35043 participants | Moderate Downgraded: risk of bias |
Total stroke RAS inhibitors vs CCBs | RR 1.19 [1.08, 1.32] | 4 studies · 34673 participants | Moderate Downgraded: risk of bias |
End stage renal failure RAS inhibitors vs CCBs | RR 0.88 [0.74, 1.05] | 4 studies · 19551 participants | Low Downgraded: risk of bias |
RAS inhibitors compared to thiazides for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause death RAS inhibitors vs thiazides | RR 1 [0.94, 1.07] | 1 study · 24309 participants | Moderate |
Total cardiovascular events RAS inhibitors vs thiazides | RR 1.05 [1, 1.11] | 2 studies · 24379 participants | Moderate |
Total heart failure RAS inhibitors vs thiazides | RR 1.19 [1.07, 1.31] | 1 study · 24309 participants | Moderate |
Total myocardial infarction RAS inhibitors vs thiazides | RR 0.93 [0.86, 1.01] | 2 studies · 24379 participants | Moderate |
Total stroke RAS inhibitors vs thiazides | RR 1.14 [1.02, 1.28] | 1 study · 24309 participants | Moderate |
End stage renal failure RAS inhibitors vs thiazides | RR 1.1 [0.88, 1.37] | 1 study · 24309 participants | Low |
RAS inhibitors compared to beta‐blockers for hypertension
Population: people with hypertension
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All cause death RAS inhibitors vs beta‐blockers | RR 0.89 [0.78, 1.01] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |
Total cardiovascular events RAS inhibitors vs beta‐blockers | RR 0.88 [0.8, 0.98] | 2 studies · 9239 participants | Low Downgraded: risk of bias, imprecision |
Total heart failure RAS inhibitors vs beta‐blockers | RR 0.95 [0.76, 1.18] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |
Total myocardial infarction RAS inhibitors vs beta‐blockers | RR 1.05 [0.86, 1.27] | 2 studies · 9239 participants | Low Downgraded: risk of bias, imprecision |
Total stroke RAS inhibitors vs beta‐blockers | RR 0.75 [0.63, 0.88] | 1 study · 9193 participants | Low Downgraded: risk of bias, imprecision |