Evidence mapPaperPMID 23966312Full record

SynthesisEuropean heart journal2014

Antihypertensive efficacy of angiotensin receptor blockers as monotherapy as evaluated by ambulatory blood pressure monitoring: a meta-analysis.

Harikrishna Makani, Sripal Bangalore, Azhar Supariwala, Jorge Romero, Edgar Argulian, Franz H Messerli

Open access · bronzeAbstract readMeta-AnalysisReview
In one paragraph

Synthesis in European heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

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  13. Perindopril for improving cardiovascular events.Vascular health and risk management · 2014
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Harikrishna MakaniDivision of Cardiology, St Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000, 10th Avenue, Suite 3B-30, New York, NY 10019, USA.
Sripal BangaloreNew York University School of Medicine, New York, NY, USA.
Azhar SupariwalaDivision of Cardiology, St Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000, 10th Avenue, Suite 3B-30, New York, NY 10019, USA.
Jorge RomeroAlbert Einstein College of Medicine/Montefiore Medical Center, New York, NY, USA.
Edgar ArgulianDivision of Cardiology, St Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000, 10th Avenue, Suite 3B-30, New York, NY 10019, USA.
Franz H MesserliDivision of Cardiology, St Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000, 10th Avenue, Suite 3B-30, New York, NY 10019, USA messerli.f@gmail.com.
St. Luke's-Roosevelt Hospital Center · USAlbert Einstein College of Medicine · USColumbia University · USNew York University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsAngiotensin receptor blockers (ARBs) are available in different dosages and it is common clinical practice to uptitrate if blood pressure goal is not achieved with the initial dose. Data on the incremental antihypertensive efficacy with uptitration are scarce. It is also unclear if antihypertensive efficacy of losartan is comparable with other ARBs. METHODS AND

resultsWe systematically reviewed PubMed/EMBASE/Cochrane databases for all randomized clinical trials until December 2012 reporting 24 h ambulatory blood pressure (ABP) for most commonly available ARBs in patients with hypertension. Reduction in ABP with ARBs was evaluated at 25% of the maximum (max) dose, 50% of the max dose, and at the max dose. Comparison was made between 24 h BP-lowering effect of losartan 50 and 100 mg and other ARBs at 50% max dose and the max dose, respectively. Sixty-two studies enrolling 15 289 patients (mean age 56 years; 60% men) with a mean duration of 10 weeks were included in the analysis. Overall, the dose-response curve with ARBs was shallow with decrease of 10.3/6.7 (systolic/diastolic), 11.7/7.6, and 13.0/8.3 mmHg with 25% max dose, 50% max dose, and with the max dose of ARBs, respectively. Losartan in the dose of 50 mg lowered ABP less well than other ARBs at 50% max dose by 2.5 mmHg systolic (P < 0.0001) and 1.8 mmHg diastolic (P = 0.0003). Losartan 100 mg lowered ABP less well than other ARBs at max dose by 3.9 mm Hg systolic (P = 0.0002) and 2.2 mmHg diastolic (P = 0.002).

conclusionIn this comprehensive analysis of the antihypertensive efficacy of ARBs by 24 h ABP, we observed a shallow dose-response curve, and uptitration marginally enhanced the antihypertensive efficacy. Blood pressure reduction with losartan at starting dose and at max dose was consistently inferior to the other ARBs.

Indexed as

AgedAngiotensin Receptor AntagonistsAntihypertensive AgentsBlood PressureBlood Pressure Monitoring, AmbulatoryDose-Response Relationship, DrugFemaleHumansHypertensionMaleRandomized Controlled Trials as TopicTreatment OutcomeAngiotensin Receptor AntagonistsAntihypertensive AgentsAmbulatory blood pressure monitoringAngiotensin receptor blockersHypertensionMeta-analysis

Identifiers

PMID23966312
PMCPMC5994844
OpenAlexW2112204400

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.