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      Efficacy and safety evaluation of Allisartan Isoproxil in patients with hypertension: a meta-analysis

      systematic-review

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          Abstract

          Objective

          This study aimed to evaluate the effectiveness and safety of Allisartan Isoproxil in the management of hypertension.

          Methods

          A comprehensive search was conducted across both English and Chinese databases, including the Cochrane Library, Embase, PubMed, Web of Science, Chinese Journal Full Text Database (CNKI), Wanfang Digital Periodical Full Text Database, and VIP Chinese Periodical Database (VIP), up to March 24, 2024. Randomized controlled trials (RCTs) investigating alisartan axetil for hypertension management were selected. Literature quality was assessed, and data were extracted for meta-analysis using Stata 15.1 software. The quality of evidence for outcome indicators was evaluated using the GRADE system level.

          Results

          Six RCTs involving 767 participants were included. Meta-analysis revealed that, compared to placebo, the Allisartan Isoproxil group exhibited a significant reduction in systolic blood pressure (SBP) [WMD = −8.08, 95% CI (−11.81, 4.10), p = 0.000] and brachial-ankle pulse wave velocity (baPWV) [SMD = −0.69, 95% CI (−1.17, 0.20), p = 0.006]. However, the reduction in diastolic blood pressure (DBP) was not statistically significant [WMD = −5.48, 95% CI (−11.07, 0.10), p = 0.054]. Additionally, compared to calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB), Allisartan Isoproxil did not significantly affect SBP [WMD = 0.20, 95% CI (−3.71, 4.10), p = 0.921] or DBP [WMD = 0.16, 95% CI (−2.11, 2.43), p = 0.891]. Allisartan Isoproxil demonstrated superior effects in increasing nitric oxide (NO) levels and decreasing endothelin (ET) levels compared to control groups [WMD = 9.56, 95% CI (6.42, 12.71), p = 0.000], [WMD = −7.42, 95% CI (−11.13, −3.71), p = 0.000], and showed a higher effective control rate of blood pressure [RR = 1.26, 95% CI (1.13, 1.41), p = 0.000]. Subgroup analysis did not reveal significant differences. Regarding safety, there were no statistically significant differences in adverse events between the Allisartan Isoproxil group and the control groups [RR = 0.99, 95% CI (0.74, 1.32), p = 0.928], and no fatal adverse events were reported.

          Conclusion

          Allisartan Isoproxil is effective in reducing SBP and baPWV, increasing NO, decreasing ET, and achieving a higher control rate of blood pressure in patients with essential hypertension. These benefits are achieved with minimal adverse reactions.

          Systematic Review Registration

          https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023467869, identifier PROSPERO CRD42023467869.

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          Most cited references58

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH)

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              2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement

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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2603620/overviewRole: Role: Role: Role: Role: Role:
                Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2272943/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Front Cardiovasc Med
                Front Cardiovasc Med
                Front. Cardiovasc. Med.
                Frontiers in Cardiovascular Medicine
                Frontiers Media S.A.
                2297-055X
                06 June 2024
                2024
                : 11
                : 1355014
                Affiliations
                [ 1 ]School of Clinical Medicine, Shandong Second Medical University , Weifang, Shandong, China
                [ 2 ]Department of Adult Internal Medicine, Qingdao Women’s and Children’s Hospital , Qingdao, Shandong, China
                Author notes

                Edited by: Qianman Peng, Harvard Medical School, United States

                Reviewed by: Jing Yu, Lanzhou University Second Hospital, China

                Konstantinos Kyriakoulis, National and Kapodistrian University of Athens, Greece

                [* ] Correspondence: Liang Chen qdfe102777@ 123456126.com
                Article
                10.3389/fcvm.2024.1355014
                11187348
                38903964
                b16e49b0-dd62-4099-9312-5a5df4a3f880
                © 2024 Zhao, Liu and Chen.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 December 2023
                : 27 May 2024
                Page count
                Figures: 11, Tables: 1, Equations: 0, References: 59, Pages: 18, Words: 0
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Cardiovascular Medicine
                Systematic Review
                Custom metadata
                Hypertension

                allisartan isoproxil,hypertension,meta-analysis,systematic review,randomized controlled trial

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