Table 2.
Evidence for effectiveness of anti-hypertensive medicines in NRDL of UEBMI——From systematic review and meta-analysis
| Dosage form | Meta-analysis /Systematic review (First author, year) | AMSTAR score | PRISMA score | Research conclusions | Sound support for effectiveness (Y / N) | |
|---|---|---|---|---|---|---|
| Calcium antagonist | ||||||
| Class A | ||||||
| Nimodipine | oral release dosage form | Chen Q, 2014 [27] | 8.5 | 25 | For patients with HICH, nimodipine combined with edaravone has significant clinical efficacy in the treatment of hypertensive cerebral hemorrhage, and can improve the functional rehabilitation of the nerves and effectively reduce the volumes of intracranial hematoma and peripheral edema. | Y |
| Nitrendipine | oral release dosage form | Du X, 2014 [32] | 8 | 21 | In lowering blood pressure, Amlodipine is better than Nitrendipine in the cost and effect. | N |
| Class B | ||||||
| Levamlodipine besylate | oral release dosage form | Zhao Z, 2015 [26] | 8.5 | 24 | Levamlodipine is more effective and safer than amlodipine in treatment of mild to moderate hypertension than, which is thus worthy of clinical application. | Y |
| Felodipine | oral release dosage form, controlled release dosage form | Zhang T, 2013 [33] | 8 | 21 | In the treatment of Chinese patients with hypertension, amlodipine both in reducing systolic or diastolic pressure were better than felodipine, no statistical significance on both heart rate and adverse drug reaction differences. | N |
| Felodipine II | controlled release dosage form | Zhang T, 2013 [33] | 8 | 21 | In the treatment of Chinese patients with hypertension, amlodipine both in reducing systolic or diastolic pressure were better than felodipine, no statistical significance on both heart rate and adverse drug reaction differences. | N |
| Lercanidipine | oral release dosage form | Ran Y, 2015 [20] | 8.5 | 23 | Based on the current evidence, the safety and compliance of lercanidipine is better than amlodipine in the treatment of mild to moderate hypertension. | Y |
| Nicardipine | injection | Jiang C, 2013 [19] | 8.5 | 24.5 | Nicardipine was safe and effective in the treatment of hypertensive emergency. | Y |
| Lacidipine | oral release dosage form | Hua Q, 2014 [18] | 9.5 | 23 | Lacidipine has been similar to amlodipine in the treatment of essential hypertension with less adverse drug reaction. | Y |
| Cilnidipine | oral release dosage form | Li S, 2012 [16] | 9 | 22.5 | Cilnidipine has the similar efficacy and safety compared with control group in treating essential hypertension. | Y |
| β-blockers | ||||||
| Class B | ||||||
| Arotinolol | oral release dosage form | Du B, 2009 [21] | 8.5 | 21.5 | In treating essential hypertension, there is no significant difference in efficacy and safety between Arotinolol and control group, such as Cilnidipine, felodipine and Imidapril. | Y |
| Labetalol | oral release dosage form | Magee LA, 2015 [29] | 9 | 24 | Labetalol is a reasonable choice for treatment of severe or non-severe hypertension in pregnancy | Y |
| Carvedilol | oral release dosage form | Chen S, 2015 [13] | 9 | 24 | Carvedilol has a greater portal hypertensive effect than propranolol. Further comparative trials of the two drugs are required to identify the effect of MAP reduction. | Y |
| Esmolol | injection | Garnockjones KP, 2012 [31] | 10 | 25 | Definitive conclusions on the efficacy of esmolol are difficult to reach, as most trials investigating esmolol have limitations such as small patient populations, and few studies investigate the same parameters. | N |
| ACEIs | ||||||
| Class B | ||||||
| Perindopril | oral release dosage form | Gasowski J, 2010 [12] | 8.5 | 24 | Perindopril is an effective antihypertensive medication. Seems not to be adversely affected by the clinical profile of the patient. | Y |
| Benazepril | oral release dosage form | Zhao S, 2015 [22] | 7.5 | 22 | Benazepril can more effectively lower the blood pressure of patients with primary hypertension than captopril. | Y |
| Fosinopril | oral release dosage form | Zeng X, 2014 [11] | 8.5 | 23.5 | The curative effect of fosinopril is almost the same as calcium antagonists in the treatment of mild to moderate essential hypertension, but superior to other types of antihypertensive drugs and shows good safety. | Y |
| Enopril folic acid | oral release dosage form | Zhang Y, 2015 [23] | 7.5 | 22 | Enopril folic acid showed better efficacy in lowering blood pressure and preventing cardiovascular accident than Enopril. | Y |
| Vasodilators | ||||||
| Class A | ||||||
| Sodium nitroprusside | injection | Dong W, 2012 [17] | 9.5 | 22 | Sodium nitroprusside is effective for the treatment of hypertensive emergency, while the ADRs are acceptable. | Y |
| Class B | ||||||
| Hydralazine | oral release dosage form | Kandler M R, 2010 [34] | 11 | 27 | Hydralazine may reduce blood pressure when compared to placebo in patients with primary hypertension, however this data is based on before and after studies, not RCTs. Furthermore, its effect on clinical outcomes remains uncertain. | N |
| Angiotensin II receptor antagonist | ||||||
| Class B | ||||||
| Irbesartan /Hydrochlorothiazide | oral release dosage form | Wu H, 2011 [24] | 8.5 | 23 | Irbesartan/hydrochlorothiazide combination therapy is more effective than control group in treating essential hypertension and there is no significant difference in safety. | Y |
| Valsartan /Hydrochlorothiazide | oral release dosage form | Jin J, 2013 [25] | 8 | 21 | In the treatment of primary hypertension, Valsartan /Hydrochlorothiazide combination has better anti-hypertension efficacy with less adverse drug reaction. | Y |
| Others | ||||||
| Class A | ||||||
| Compound reserpine | oral release dosage form | Hu L, 2012 [30] | 9 | 25.5 | Based on current research evidence, Compound reserpine tablets are safe and effective. | Y |
| Compound reserpine ammonia benzene pteridine | oral release dosage form | Wu Y, 2009 [28] | 9 | 23 | Compound reserpine ammonia benzene pteridine appears to have the same effect as other anti-hypertensive drugs without having more adverse events. | Y |
| Class B | ||||||
| Doxazosin | oral release dosage form | Ke Z, 2015 [14] | 8.5 | 24 | Doxazosin has affirmed effect on mild to moderate essential hypertension, with little side effect, good patient tolerance, especially for hypertension patients with benign prostatic hyperplasia. | Y |
| Urapidil | injection | Zhou X, 2016 [15] | 7.5 | 21.5 | Urapidil and conventional vasedilator like Nitroglycerin are effective to heart failure with hypertension. For lowering blood pressure, their efficacy are equal, but for reducing patients BNP and heart rate, Urapidil is better than the other. | Y |
| Reserpine | oral release dosage form | Shamon S D, 2009 [35] | 9 | 25 | Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs. However, we could not make definite conclusions regarding the dose-response pattern because of the small number of included trials. More RCTs are needed to assess the effects of reserpine on blood pressure and to determine the dose-related safety profile before the role of this drug in the treatment of primary hypertension can be established. | N |