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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 2

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Forest plot of comparison: 1 ACE inhibitors versus placebo, outcome: 1.1 Cardiovascular events.
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Figure 3

Forest plot of comparison: 1 ACE inhibitors versus placebo, outcome: 1.1 Cardiovascular events.

Forest plot of comparison: 1 ACE inhibitors versus placebo, outcome: 1.3 Maximum walking distance.
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Figure 4

Forest plot of comparison: 1 ACE inhibitors versus placebo, outcome: 1.3 Maximum walking distance.

Forest plot of comparison: 2 Calcium antagonists versus placebo, outcome: 2.1 Degree of diameter stenosis.
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Figure 5

Forest plot of comparison: 2 Calcium antagonists versus placebo, outcome: 2.1 Degree of diameter stenosis.

Forest plot of comparison: 2 Calcium antagonists versus placebo, outcome: 2.3 Arterial intima‐media thickness.
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Figure 6

Forest plot of comparison: 2 Calcium antagonists versus placebo, outcome: 2.3 Arterial intima‐media thickness.

Comparison 1 ACE inhibitors versus placebo, Outcome 1 Cardiovascular events.
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Analysis 1.1

Comparison 1 ACE inhibitors versus placebo, Outcome 1 Cardiovascular events.

Comparison 1 ACE inhibitors versus placebo, Outcome 2 Claudication distance.
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Analysis 1.2

Comparison 1 ACE inhibitors versus placebo, Outcome 2 Claudication distance.

Comparison 1 ACE inhibitors versus placebo, Outcome 3 Maximum walking distance.
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Analysis 1.3

Comparison 1 ACE inhibitors versus placebo, Outcome 3 Maximum walking distance.

Comparison 1 ACE inhibitors versus placebo, Outcome 4 Ankle brachial pressure index.
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Analysis 1.4

Comparison 1 ACE inhibitors versus placebo, Outcome 4 Ankle brachial pressure index.

Comparison 2 Calcium antagonists versus placebo, Outcome 1 Degree of diameter stenosis.
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Analysis 2.1

Comparison 2 Calcium antagonists versus placebo, Outcome 1 Degree of diameter stenosis.

Comparison 2 Calcium antagonists versus placebo, Outcome 2 Ankle brachial pressure index.
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Analysis 2.2

Comparison 2 Calcium antagonists versus placebo, Outcome 2 Ankle brachial pressure index.

Comparison 2 Calcium antagonists versus placebo, Outcome 3 Arterial intima‐media thickness.
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Analysis 2.3

Comparison 2 Calcium antagonists versus placebo, Outcome 3 Arterial intima‐media thickness.

Comparison 3 Thiazide diuretics versus alpha‐adrenoreceptor blocking drugs, Outcome 1 Arterial intima‐media thickness (IMT).
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Analysis 3.1

Comparison 3 Thiazide diuretics versus alpha‐adrenoreceptor blocking drugs, Outcome 1 Arterial intima‐media thickness (IMT).

Study

Telmisartan (n = 18)

Placebo (n = 18)

Zankl 2010

Median (95% CI)

Median (95% CI)

Zankl 2010

191 (157 ‐ 226)

132 (103 ‐ 192)

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Analysis 4.1

Comparison 4 Angiotensin‐II receptor antagonist versus placebo, Outcome 1 Maximum walking distance at 12 months (m).

Study

Telmisartan (n = 18)

Placebo (n = 18)

Zankl 2010

Median (95% CI)

Median (95% CI)

Zankl 2010

0.08 (0.07 ‐ 0.09)

0.09 (0.08 ‐ 1.00)

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Analysis 4.2

Comparison 4 Angiotensin‐II receptor antagonist versus placebo, Outcome 2 Intima‐media thickness at 12 months (cm).

Study

Telmisartan (n = 18)

Placebo (n = 18)

Zankl 2010

Median (95% CI)

Median (95% CI)

Zankl 2010

0.60 (0.60 ‐ 0.77)

0.52 (0.48 ‐ 0.67)

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Analysis 4.3

Comparison 4 Angiotensin‐II receptor antagonist versus placebo, Outcome 3 Ankle‐brachial pressure index.

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 1 Change in intermittent claudication distance.
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Analysis 5.1

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 1 Change in intermittent claudication distance.

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 2 Absolute claudication distance.
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Analysis 5.2

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 2 Absolute claudication distance.

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 3 Change in ankle brachial pressure index.
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Analysis 5.3

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 3 Change in ankle brachial pressure index.

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 4 All‐cause mortality.
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Analysis 5.4

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 4 All‐cause mortality.

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 5 Non‐fatal cardiovascular events.
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Analysis 5.5

Comparison 5 Beta‐adrenoreceptor blockers versus thiazide diuretics, Outcome 5 Non‐fatal cardiovascular events.

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 1 All‐cause mortality.
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Analysis 6.1

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 1 All‐cause mortality.

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 2 Ankle brachial pressure index.
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Analysis 6.2

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 2 Ankle brachial pressure index.

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 3 Intermittent claudication distance.
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Analysis 6.3

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 3 Intermittent claudication distance.

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 4 Absolute claudication distance.
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Analysis 6.4

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 4 Absolute claudication distance.

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 5 Need for revascularisation.
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Analysis 6.5

Comparison 6 Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers, Outcome 5 Need for revascularisation.

Comparison 7 Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy, Outcome 1 Composite endpoint of death, non‐fatal MI, or non‐fatal stroke.
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Analysis 7.1

Comparison 7 Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy, Outcome 1 Composite endpoint of death, non‐fatal MI, or non‐fatal stroke.

Comparison 7 Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy, Outcome 2 Composite endpoint of death, non‐fatal MI or stroke, and revascularisation.
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Analysis 7.2

Comparison 7 Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy, Outcome 2 Composite endpoint of death, non‐fatal MI or stroke, and revascularisation.

Comparison 1. ACE inhibitors versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cardiovascular events Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Claudication distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Maximum walking distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Ankle brachial pressure index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

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Comparison 1. ACE inhibitors versus placebo
Comparison 2. Calcium antagonists versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Degree of diameter stenosis Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Ankle brachial pressure index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Arterial intima‐media thickness Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

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Comparison 2. Calcium antagonists versus placebo
Comparison 3. Thiazide diuretics versus alpha‐adrenoreceptor blocking drugs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Arterial intima‐media thickness (IMT) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

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Comparison 3. Thiazide diuretics versus alpha‐adrenoreceptor blocking drugs
Comparison 4. Angiotensin‐II receptor antagonist versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maximum walking distance at 12 months (m) Show forest plot

Other data

No numeric data

2 Intima‐media thickness at 12 months (cm) Show forest plot

Other data

No numeric data

3 Ankle‐brachial pressure index Show forest plot

Other data

No numeric data

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Comparison 4. Angiotensin‐II receptor antagonist versus placebo
Comparison 5. Beta‐adrenoreceptor blockers versus thiazide diuretics

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in intermittent claudication distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Absolute claudication distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Change in ankle brachial pressure index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 All‐cause mortality Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5 Non‐fatal cardiovascular events Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

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Comparison 5. Beta‐adrenoreceptor blockers versus thiazide diuretics
Comparison 6. Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 All‐cause mortality Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Ankle brachial pressure index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Intermittent claudication distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Absolute claudication distance Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Need for revascularisation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

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Comparison 6. Beta‐adrenoreceptor blockers versus beta‐adrenoreceptor blockers
Comparison 7. Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Composite endpoint of death, non‐fatal MI, or non‐fatal stroke Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Composite endpoint of death, non‐fatal MI or stroke, and revascularisation Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

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Comparison 7. Calcium antagonist‐based strategy versus beta‐adrenoreceptor blocker‐based strategy