Efficacy and Safety of Aldosterone Synthase Inhibitors for Resistant Hypertension: A Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
Background: Compared to patients with controllable hypertension, those with resistant hypertension (RH) have a higher incidence of cardiovascular complications, including stroke, left ventricular hypertrophy, and congestive heart failure. Therefore, an urgent need exists for improved management and control, along with more effective medications. Aldosterone synthase inhibitors (ASIs) are newly emerging drugs that have gradually attracted an increasing amount of attention. Methods: The Cochrane Library, PubMed, Embase, and ClinicalTrials.gov databases were systematically searched to identify all literature on ASIs and resistant hypertension. Additionally, the reference lists of the included articles were manually searched. The quality of the identified studies was assessed using the Cochrane Bias Risk Tool. Results: This study comprised four randomized controlled trials (RCTs), involving 776 participants. Different doses of ASIs were used, with treatment durations ranging from 7 to 12 weeks. The selected study population included individuals with resistant hypertension and healthy adults. Systolic blood pressure (SBP) had a pooled effect size of standardized mean difference (SMD) = –0.24, with a 95% confidence interval (CI) of [–0.46, –0.03], indicating a statistically significant difference (p = 0.026); however, diastolic blood pressure (DBP) had a pooled effect size of SMD = –0.13, with a 95% CI of [–0.40, 0.15], indicating no significant difference (p = 0.359). Similarly, subgroup analyses yielded comparable results. Notably, the risk of adverse events in the ASI group was greater than that in the control group, with a risk ratio of 1.32 and a 95% CI of [1.04, 1.66], indicating a significant difference (p = 0.02). There was no statistically significant difference in severe adverse events between the treatment group and the control group (p = 0.532). Conclusions: ASIs have shown benefits in controlling SBP in patients with resistant hypertension, although their effects on DBP appear to be limited. Given the observation period of only 12 weeks, the potential for increased adverse event risks with their use warrants further attention. Considering the relatively small number of trials included and the limited sample size in this study, future research should focus on expanding the sample size and extending the follow-up duration to more precisely define the clinical role and value of ASIs. Additionally, further investigation into the underlying mechanisms of action of these inhibitors is necessary to provide theoretical support for optimizing treatment strategies for resistant hypertension and related conditions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,041 | 0,008 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».