Scolaris Content Display Scolaris Content Display

PRISMA flow diagram
Figures and Tables -
Figure 1

PRISMA flow diagram

Comparison 1 Doxazosin vs Placebo, Outcome 1 Change in trough SBP.
Figures and Tables -
Analysis 1.1

Comparison 1 Doxazosin vs Placebo, Outcome 1 Change in trough SBP.

Comparison 1 Doxazosin vs Placebo, Outcome 2 Change in trough DBP.
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Analysis 1.2

Comparison 1 Doxazosin vs Placebo, Outcome 2 Change in trough DBP.

Comparison 1 Doxazosin vs Placebo, Outcome 3 Change in peak SBP.
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Analysis 1.3

Comparison 1 Doxazosin vs Placebo, Outcome 3 Change in peak SBP.

Comparison 1 Doxazosin vs Placebo, Outcome 4 Change in peak DBP.
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Analysis 1.4

Comparison 1 Doxazosin vs Placebo, Outcome 4 Change in peak DBP.

Comparison 1 Doxazosin vs Placebo, Outcome 5 Change in trough heart rate.
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Analysis 1.5

Comparison 1 Doxazosin vs Placebo, Outcome 5 Change in trough heart rate.

Comparison 1 Doxazosin vs Placebo, Outcome 6 Change in peak heart rate.
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Analysis 1.6

Comparison 1 Doxazosin vs Placebo, Outcome 6 Change in peak heart rate.

Comparison 1 Doxazosin vs Placebo, Outcome 7 Total withdrawals due to adverse effects.
Figures and Tables -
Analysis 1.7

Comparison 1 Doxazosin vs Placebo, Outcome 7 Total withdrawals due to adverse effects.

Comparison 2 Prazosin vs Placebo, Outcome 1 Change in trough SBP.
Figures and Tables -
Analysis 2.1

Comparison 2 Prazosin vs Placebo, Outcome 1 Change in trough SBP.

Comparison 2 Prazosin vs Placebo, Outcome 2 Change in trough DBP.
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Analysis 2.2

Comparison 2 Prazosin vs Placebo, Outcome 2 Change in trough DBP.

Comparison 2 Prazosin vs Placebo, Outcome 3 Change in trough heart rate.
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Analysis 2.3

Comparison 2 Prazosin vs Placebo, Outcome 3 Change in trough heart rate.

Comparison 2 Prazosin vs Placebo, Outcome 4 Total withdrawals due to adverse effects.
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Analysis 2.4

Comparison 2 Prazosin vs Placebo, Outcome 4 Total withdrawals due to adverse effects.

Comparison 3 Terazosin vs Placebo, Outcome 1 Change in trough SBP.
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Analysis 3.1

Comparison 3 Terazosin vs Placebo, Outcome 1 Change in trough SBP.

Comparison 3 Terazosin vs Placebo, Outcome 2 Change in trough DBP.
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Analysis 3.2

Comparison 3 Terazosin vs Placebo, Outcome 2 Change in trough DBP.

Table 1. Overview of the 10 studies investigating alpha blockers as monotherapy

Alpha blocker

Dose range (mg/day)

Number of studies

Alpha patients (n)

Placebo patients (n)

Mean duration (weeks)

Mean age (years)

Baseline BP (mm Hg)

Bunazosin

3‐12

1

12

4

8.0

Not reported

163.3/102.8

Doxazosin

2‐12

3

347

125

7.1

58.1

157.8/101.4

Prazosin

2.5‐20

2

108

32

4.2

55.1

151.9/99.9

Terazosin

5‐20

4

203

159

4.0

Not reported

155.4/101.4

Figures and Tables -
Table 1. Overview of the 10 studies investigating alpha blockers as monotherapy
Table 2. Summary of the blood pressure lowering efficacy of alpha blockers

Alpha blocker

Lowest effective dose (mg/day)

Lowest dose with near maximal BP lowering (mg/day)

Near maximal trough SBP lowering

Near maximal trough DBP lowering

Trough SBP lowering (mm Hg), 95% CI

Trough DBP lowering (mm Hg), 95% CI

Bunazosin

Not estimable

Not estimable

Not estimable

Not estimable

Not estimable

Not estimable

Doxazosin

4

Not estimable

Not estimable

Not estimable

‐6.42 (‐10.12, ‐2.80)

‐3.53 (‐4.99, ‐2.07)

Prazosin

10

Not estimable

Not estimable

Not estimable

‐10.38 (‐16.21, ‐4.56)

‐6.90 (‐9.79, ‐4.01)

Terazosin

5

Not estimable

Not estimable

Not estimable

‐6.59 (‐10.22, ‐2.96)

‐4.40 (‐5.95, ‐2.84)

Figures and Tables -
Table 2. Summary of the blood pressure lowering efficacy of alpha blockers
Comparison 1. Doxazosin vs Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in trough SBP Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 2 mg

2

93

Mean Difference (IV, Fixed, 95% CI)

‐5.03 [‐10.71, 0.64]

1.2 4 mg

2

91

Mean Difference (IV, Fixed, 95% CI)

‐5.84 [‐11.44, ‐0.23]

1.3 8 mg

2

91

Mean Difference (IV, Fixed, 95% CI)

‐7.24 [‐12.93, ‐1.56]

1.4 12 mg

1

55

Mean Difference (IV, Fixed, 95% CI)

‐6.1 [‐15.27, 3.07]

2 Change in trough DBP Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 2 mg

2

93

Mean Difference (IV, Fixed, 95% CI)

‐3.01 [‐6.43, 0.42]

2.2 4 mg

3

326

Mean Difference (IV, Fixed, 95% CI)

‐3.36 [‐5.06, ‐1.66]

2.3 8 mg

2

90

Mean Difference (IV, Fixed, 95% CI)

‐4.13 [‐7.61, ‐0.65]

2.4 12 mg

1

56

Mean Difference (IV, Fixed, 95% CI)

‐3.8 [‐8.64, 1.04]

3 Change in peak SBP Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 2 mg

1

44

Mean Difference (IV, Fixed, 95% CI)

‐6.8 [‐13.96, 0.36]

3.2 4 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

‐6.0 [‐13.08, 1.08]

3.3 8 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

‐12.90 [‐20.34, ‐5.46]

4 Change in peak DBP Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 2 mg

1

44

Mean Difference (IV, Fixed, 95% CI)

‐4.30 [‐8.92, 0.32]

4.2 4 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

‐4.4 [‐9.02, 0.22]

4.3 8 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

‐8.5 [‐13.32, ‐3.68]

5 Change in trough heart rate Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 2 mg

1

44

Mean Difference (IV, Fixed, 95% CI)

‐1.90 [‐6.62, 2.82]

5.2 4 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

‐1.5 [‐6.22, 3.22]

5.3 8 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

1.0 [‐4.67, 6.67]

6 Change in peak heart rate Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 2 mg

1

44

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐4.82, 4.62]

6.2 4 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

1.30 [‐3.42, 6.02]

6.3 8 mg

1

35

Mean Difference (IV, Fixed, 95% CI)

3.2 [‐2.47, 8.87]

7 Total withdrawals due to adverse effects Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 2‐8 mg

1

135

Risk Ratio (M‐H, Fixed, 95% CI)

1.94 [0.24, 15.54]

7.2 2‐12 mg

1

248

Risk Ratio (M‐H, Fixed, 95% CI)

2.71 [0.66, 11.13]

Figures and Tables -
Comparison 1. Doxazosin vs Placebo
Comparison 2. Prazosin vs Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in trough SBP Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 2.5 mg GITS

1

65

Mean Difference (IV, Fixed, 95% CI)

‐3.60 [‐11.86, 4.66]

1.2 3 mg

1

28

Mean Difference (IV, Fixed, 95% CI)

‐3.0 [‐13.88, 7.88]

1.3 10 mg GITS

1

72

Mean Difference (IV, Fixed, 95% CI)

‐9.20 [‐17.23, ‐1.17]

1.4 20 mg GITS

1

68

Mean Difference (IV, Fixed, 95% CI)

‐11.7 [‐20.17, ‐3.23]

2 Change in trough DBP Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 2.5 mg GITS

1

65

Mean Difference (IV, Fixed, 95% CI)

‐2.4 [‐6.54, 1.74]

2.2 3 mg

1

28

Mean Difference (IV, Fixed, 95% CI)

‐4.0 [‐8.00, 2.00]

2.3 10 mg GITS

1

72

Mean Difference (IV, Fixed, 95% CI)

‐6.80 [‐10.87, ‐2.73]

2.4 20 mg GITS

1

68

Mean Difference (IV, Fixed, 95% CI)

‐7.0 [‐11.11, ‐2.89]

3 Change in trough heart rate Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 2.5 mg GITS

1

65

Mean Difference (IV, Fixed, 95% CI)

2.1 [‐2.53, 6.73]

3.2 10 mg GITS

1

72

Mean Difference (IV, Fixed, 95% CI)

1.80 [‐2.79, 6.39]

3.3 20 mg GITS

1

68

Mean Difference (IV, Fixed, 95% CI)

2.9 [‐1.69, 7.49]

4 Total withdrawals due to adverse effects Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 2.5‐20 mg GITS

1

220

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.21, 2.43]

Figures and Tables -
Comparison 2. Prazosin vs Placebo
Comparison 3. Terazosin vs Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in trough SBP Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 5 mg

1

79

Mean Difference (IV, Fixed, 95% CI)

‐6.9 [‐12.20, ‐1.60]

1.2 10 mg

1

93

Mean Difference (IV, Fixed, 95% CI)

‐6.10 [‐12.08, ‐0.12]

1.3 20 mg

1

64

Mean Difference (IV, Fixed, 95% CI)

‐6.80 [‐15.73, 2.13]

2 Change in trough DBP Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 5 mg

2

205

Mean Difference (IV, Fixed, 95% CI)

‐4.92 [‐6.87, ‐2.97]

2.2 10 mg

1

93

Mean Difference (IV, Fixed, 95% CI)

‐3.2 [‐6.54, 0.14]

2.3 20 mg

1

64

Mean Difference (IV, Fixed, 95% CI)

‐3.9 [‐7.95, 0.15]

Figures and Tables -
Comparison 3. Terazosin vs Placebo