Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.

<h4>Objective(s)</h4>Several studies have assessed the effect of angiotensin II receptor blockers (ARBs) on peripheral endothelial dysfunction as measured by flow-mediated vasodilatation (FMD), a widely-used indicator for endothelial function. We conducted a meta-analysis to investigate...

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Autores principales:	Shuang Li, Yan Wu, Ge Yu, Qing Xia, Yawei Xu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/65adcbad96ca46678d4d26ded4dda198
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spelling	oai:doaj.org-article:65adcbad96ca46678d4d26ded4dda1982021-11-18T08:30:02ZAngiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.1932-620310.1371/journal.pone.0090217https://doaj.org/article/65adcbad96ca46678d4d26ded4dda1982014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24595033/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective(s)</h4>Several studies have assessed the effect of angiotensin II receptor blockers (ARBs) on peripheral endothelial dysfunction as measured by flow-mediated vasodilatation (FMD), a widely-used indicator for endothelial function. We conducted a meta-analysis to investigate the effect in comparison to placebo or no treatment and other antihypertensives.<h4>Methods</h4>MEDLINE, Cochrane library and EMBASE were searched to September 2013 for randomized controlled trials (RCTs) that assessed the effect of ARBs versus placebo or no treatment and other antihypertensives (angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), β-blockers, diuretics) by forearm FMD. Furthermore, we also use meta-regression to analyze the relationship between the endothelial function and the duration of ARBs treatments.<h4>Results</h4>In 11 trials including 590 patients, ARBs (n = 315) significantly improved FMD (1.36%, 95% confidence internal [CI]:1.28 to 1.44) versus placebo or no treatment (n = 275). In 16 trials that included 1028 patients, ARBs (n = 486) had a significant effect (0.59%, 95% CI: 0.25 to 0.94) on FMD when compared with other antihypertensives (n = 542). In 8 trials, ARBs (n = 174) had no significant effect (-0.14%, 95% CI: -0.32 to 0.03) compared with ACEI (n = 173). Compared with others, the benefits of ARBs, respectively, were 1.67% (95% CI: 0.65 to 0.93) in 7 trials with CCBs, 0.79% (95% CI: 0.42 to 1.01) with β-blockers in 3 trials and 0.9% (95% CI: 0.77 to 1.03) with diuretics in 3 trials. Importantly, we found ARBs were less effective in a long time span (95% CI: -1.990 to -0.622) than the first 6 months (95% CI: -0.484 to 0.360).<h4>Conclusions</h4>This study shows that ARBs improve peripheral endothelial function and are superior to CCBs, β-blockers and diuretics. However, the effect couldn't be maintained for a long time. In addition, there was no significant difference between ARBs and ACEI.Shuang LiYan WuGe YuQing XiaYawei XuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 3, p e90217 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shuang Li Yan Wu Ge Yu Qing Xia Yawei Xu Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
description	<h4>Objective(s)</h4>Several studies have assessed the effect of angiotensin II receptor blockers (ARBs) on peripheral endothelial dysfunction as measured by flow-mediated vasodilatation (FMD), a widely-used indicator for endothelial function. We conducted a meta-analysis to investigate the effect in comparison to placebo or no treatment and other antihypertensives.<h4>Methods</h4>MEDLINE, Cochrane library and EMBASE were searched to September 2013 for randomized controlled trials (RCTs) that assessed the effect of ARBs versus placebo or no treatment and other antihypertensives (angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), β-blockers, diuretics) by forearm FMD. Furthermore, we also use meta-regression to analyze the relationship between the endothelial function and the duration of ARBs treatments.<h4>Results</h4>In 11 trials including 590 patients, ARBs (n = 315) significantly improved FMD (1.36%, 95% confidence internal [CI]:1.28 to 1.44) versus placebo or no treatment (n = 275). In 16 trials that included 1028 patients, ARBs (n = 486) had a significant effect (0.59%, 95% CI: 0.25 to 0.94) on FMD when compared with other antihypertensives (n = 542). In 8 trials, ARBs (n = 174) had no significant effect (-0.14%, 95% CI: -0.32 to 0.03) compared with ACEI (n = 173). Compared with others, the benefits of ARBs, respectively, were 1.67% (95% CI: 0.65 to 0.93) in 7 trials with CCBs, 0.79% (95% CI: 0.42 to 1.01) with β-blockers in 3 trials and 0.9% (95% CI: 0.77 to 1.03) with diuretics in 3 trials. Importantly, we found ARBs were less effective in a long time span (95% CI: -1.990 to -0.622) than the first 6 months (95% CI: -0.484 to 0.360).<h4>Conclusions</h4>This study shows that ARBs improve peripheral endothelial function and are superior to CCBs, β-blockers and diuretics. However, the effect couldn't be maintained for a long time. In addition, there was no significant difference between ARBs and ACEI.
format	article
author	Shuang Li Yan Wu Ge Yu Qing Xia Yawei Xu
author_facet	Shuang Li Yan Wu Ge Yu Qing Xia Yawei Xu
author_sort	Shuang Li
title	Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
title_short	Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
title_full	Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
title_fullStr	Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
title_full_unstemmed	Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
title_sort	angiotensin ii receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/65adcbad96ca46678d4d26ded4dda198
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Angiotensin II receptor blockers improve peripheral endothelial function: a meta-analysis of randomized controlled trials.

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