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Inicio Hipertensión y Riesgo Vascular Comparison of the effectiveness of aliskiren and ramipril for the management of ...
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Original article
Available online 11 December 2024
Comparison of the effectiveness of aliskiren and ramipril for the management of hypertension: A systematic review and meta-analysis
Comparación de la eficacia de aliskiren y ramipril para el tratamiento de la hipertensión: una revisión sistemática y un metaanálisis
T. Alama,
Corresponding author
talam400@gmail.com

Corresponding author.
, M. Asif Ansarib
a School of Pharmaceutical Sciences, Lingaya's Vidyapeeth, Faridabad, Haryana 121002, India
b Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia, Hamdard, New Delhi 110062, India
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Table 1. Baseline characteristics of included clinical trials.
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Abstract
Objective

Ramipril is an important option in the management of hypertension, while the role of aliskiren is still up for debate. We aim to meta-analyse and compare the effect of aliskiren with ramipril by measuring mean difference in systolic blood pressure (mdSBP) and mean difference in diastolic blood pressure (mdDBP).

Methods

The search was conducted using the PubMed and Cochrane databases for eligible randomized clinical trials (RCTs) to perform a meta-analysis from January 2000 to May 2024. RCTs that included hypertensive patients who were under either aliskiren or ramipril treatment were included in the analysis. The risk of bias was evaluated using RoB 2.0. This study is registered with PROSPERO: CRD42024577105.

Results

Four studies were included: two studies were carried out for 2 months, and two were carried out for 6 months, including 693 and 329 patients, respectively, with mild to moderate hypertension and a mean age of 55.2 years. After 2 months, mdDBP was found to be significant (mdDBP=0.85mmHg, 95% CI: 0.73–0.97, I2=0%), but mdSBP was found to be non-significant (mdSBP=0.0mmHg, 95% CI: −0.17–0.17, I2=0%). There was a significant difference in the mdSBP (mdSBP=3.15mmHg, 95% CI: 2.13–4.17, I2=84%) and mdDBP (mdDBP=1.2mmHg, 95% CI: 1.09–1.31, I2=0%) at 6 months.

Conclusion

Aliskiren provides, in the short term, a slight improvement in BP in non-elderly hypertensive patients without diabetes or previous cardio-cerebrovascular disease.

Keywords:
Aliskiren
Ramipril
Hypertension
Meta-analysis
Resumen
Objetivo

Aliskiren y ramipril son piedras angulares en el tratamiento de la hipertensión. El objetivo es metaanalizar y comparar el efecto de aliskiren con ramipril en los pacientes hipertensos midiendo la diferencia de medias en la presión arterial sistólica (PASmd) y la diferencia de medias en la presión arterial diastólica (PADmd).

Métodos

La búsqueda se realizó utilizando las bases de datos PubMed y Cochrane para ensayos clínicos aleatorios (ECA) elegibles para realizar un metaanálisis desde enero de 2000 hasta mayo de 2024. En el análisis se incluyeron los ECA que incluían pacientes hipertensos que estaban bajo tratamiento con aliskiren o ramipril. El riesgo de sesgo se evaluó mediante el riesgo de sesgo Cochrane 2 (RoB 2). Este estudio está registrado ante PRÓSPERO: CRD42024577105.

Resultados

Se incluyeron 4 estudios: 2 estudios se realizaron durante 2 meses y 2 durante 6 meses, incluyendo 693 y 329 pacientes, respectivamente, con hipertensión leve a moderada y un rango de edad promedio de 47 a 66,8 años. Después de 2 meses, se encontró que la PADmd era significativa (diferencia de medias: 0,85mmHg; IC: 0,73-0,97; I2=0%), pero la PASmd no era significativa (diferencia de medias: 0,0mmHg; IC: −0,17-0,17; I2=0%). Hubo una diferencia significativa en la PASmd (diferencia de medias: 3,15mmHg; IC: 2,13-4,17; I2=84%) y la PADmd (diferencia de medias: 1,2mmHg; IC: 1,09-1,31; I2=0%) a los 6 meses.

Conclusión

Aliskiren proporciona, a corto plazo, una ligera mejoría de la PA en los pacientes hipertensos no ancianos sin diabetes ni enfermedad cardio-cerebrovascular previa.

Palabras clave:
Aliskiren
Ramipril
Hipertensión
Metaanálisis

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