Aliskiren vs. Angiotensin Receptor Blockers in Hypertension: Meta-Analysis of Randomized Controlled Trials
American Journal of Hypertension,  Evidence Based Medicine  Clinical Article

Gao D et al. - Aliskiren is as effective as angiotensin receptor blockers (ARBs) (losartan, valsartan, and irbesartan) in controlling blood pressure (BP) and does not differ from ARBs in risk of adverse events.

Methods
  • Reports of randomized controlled trials (RCTs) comparing aliskiren and ARBs in patients with hypertension were selected by a search of the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE.
  • The main outcome measures were reduction in diastolic BP (DBP) and systolic BP (SBP) and rates of therapeutic response and BP control.
  • The authors also compared the tolerability of aliskiren and ARBs.
  • Revman v5.0 was used to obtain the pooled estimates.

Results
  • The authors analyzed data from 10 reports of trials involving 3,732 participants.
  • DBP and SBP reduction did not differ between aliskiren and ARBs (weighted mean difference (WMD), -0.18; 95% confidence interval (CI), -1.07 to 0.71, and WMD, 0.15; 95% CI, -1.38 to 1.69, respectively).
  • Aliskiren and ARB treatment did not differ in rates of BP control or therapeutic response.
  • Moreover, aliskiren and ARB treatment led to a similar number of adverse events, severe adverse events, and withdrawal due to adverse events.

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