Summary of findings 5. First‐line calcium channel blocker compared to placebo for hypertension.
| First‐line calcium channel blocker (CCB) compared to placebo for hypertension | ||||||
| Patient or population: adult patients with primary hypertension Setting: outpatient Intervention: First‐line CCB (mean duration 2.5 years) Comparison: placebo or untreated | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with Placebo | Risk with CCB | |||||
| Total mortality | 60 per 1000 | 51 per 1000 (41 to 65) | RR 0.86 (0.68 to 1.09) | 4695 (1 RCT) | ⊕⊕⊝⊝ LOW 1,2 | Not significant |
| Total stroke | 34 per 1000 | 19 per 1000 (14 to 28) | RR 0.58 (0.41 to 0.84) | 4695 (1 RCT) | ⊕⊕⊝⊝ LOW 1,2 | ARR = 1.5% NNTB = 67 |
| Total coronary heart disease (CHD) | 31 per 1000 | 24 per 1000 (17 to 34) | RR 0.77 (0.55 to 1.09) | 4695 (1 RCT) | ⊕⊕⊝⊝ LOW 1,2 | Not significant |
| Total cardiovascular events | 81 per 1000 | 57 per 1000 (46 to 70) | RR 0.71 (0.57 to 0.87) | 4695 (1 RCT) | ⊕⊕⊝⊝ LOW 1,2 | ARR = 2.4% NNTB = 42 |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; RCT: randomized controlled trial; ARR: Absolute risk reduction; ARI: Absolute risk increase; NNTB: Number needed to treat for an additional beneficial outcome. | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1. Downgraded due to imprecision (wide confidence intervals).
2. Downgraded by 1 more level as there was only 1 trial