Tratamiento de la hipertensión en la enfermedad vascular periférica
Appendices
Appendix 1. CENTRAL search strategy
| #1 | MeSH descriptor: [Arteriosclerosis] this term only | 893 |
| #2 | MeSH descriptor: [Arteriolosclerosis] this term only | 0 |
| #3 | MeSH descriptor: [Arteriosclerosis Obliterans] this term only | 71 |
| #4 | MeSH descriptor: [Atherosclerosis] this term only | 382 |
| #5 | MeSH descriptor: [Arterial Occlusive Diseases] this term only | 755 |
| #6 | MeSH descriptor: [Intermittent Claudication] this term only | 711 |
| #7 | MeSH descriptor: [Ischemia] this term only | 753 |
| #8 | MeSH descriptor: [Peripheral Vascular Diseases] explode all trees | 2150 |
| #9 | MeSH descriptor: [Vascular Diseases] this term only | 381 |
| #10 | MeSH descriptor: [Leg] explode all trees and with qualifiers: [Blood supply ‐ BS] | 1075 |
| #11 | MeSH descriptor: [Femoral Artery] explode all trees | 720 |
| #12 | MeSH descriptor: [Popliteal Artery] explode all trees | 250 |
| #13 | MeSH descriptor: [Iliac Artery] explode all trees | 151 |
| #14 | MeSH descriptor: [Tibial Arteries] explode all trees | 29 |
| #15 | (atherosclero* or arteriosclero* or PVD or PAOD or PAD) | 17195 |
| #16 | (arter*) near (*occlus* or steno* or obstuct* or lesio* or block* or obliter*) | 4872 |
| #17 | (vascular) near (*occlus* or steno* or obstuct* or lesio* or block* or obliter*) | 1378 |
| #18 | (vein*) near (*occlus* or steno* or obstuct* or lesio* or block* or obliter*) | 713 |
| #19 | (veno*) near (*occlus* or steno* or obstuct* or lesio* or block* or obliter*) | 976 |
| #20 | (peripher*) near (*occlus* or steno* or obstuct* or lesio* or block* or obliter*) | 1358 |
| #21 | peripheral near/3 dis* | 3243 |
| #22 | arteriopathic | 10 |
| #23 | (claudic* or hinken*) | 1436 |
| #24 | (isch* or CLI) | 16827 |
| #25 | dysvascular* | 14 |
| #26 | leg near/4 (obstruct* or occlus* or steno* or block* or obliter*) | 176 |
| #27 | limb near/4 (obstruct* or occlus* or steno* or block* or obliter*) | 228 |
| #28 | (lower near/3 extrem*) near/4 (obstruct* or occlus* or steno* or block* or obliter*) | 137 |
| #29 | (aort* or iliac or femoral or popliteal or femoro* or fempop* or crural) near/3 (obstruct* or occlus*) | 326 |
| #30 | #1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 | 39632 |
| #31 | MeSH descriptor: [Hypertension] explode all trees | 12993 |
| #32 | MeSH descriptor: [Antihypertensive Agents] explode all trees | 6048 |
| #33 | MeSH descriptor: [Adrenergic beta‐Antagonists] explode all trees | 3978 |
| #34 | MeSH descriptor: [Angiotensin‐Converting Enzyme Inhibitors] explode all trees | 3532 |
| #35 | MeSH descriptor: [Diuretics] explode all trees | 1964 |
| #36 | MeSH descriptor: [Calcium Channel Blockers] explode all trees | 2538 |
| #37 | (hyperten*):ti,ab,kw in Trials | 25487 |
| #38 | antihypertensi* or anti‐hypertensi* in Trials | 10872 |
| #39 | (calcium near/3 (antag* or block*)) in Trials | 5111 |
| #40 | (amlodipin* or diltiazem or diltiazam or felodipin* or nicardipin* or nifedipin* or nimodipin* or nisoldipin* or nitrendipin* or verapamil):ti,ab,kw in Trials | 8923 |
| #41 | (diureti*):ti,ab,kw in Trials | 4885 |
| #42 | (angiotensin near/3 inhibitor*):ti,ab,kw in Trials | 4783 |
| #43 | (alacepril or altiopril or benazepril or captopril or ceronapril or cilazapril or delapril or derapril or enalapril or fosinopril or idapril or imidapril or lisinopril or moexipril or moveltipril or pentopril or perindopril or quinapril or ramipril or spirapril or temocapril or trandolapril or zofenopril):ti,ab,kw in Trials | 6945 |
| #44 | ACE next inhibitor* in Trials | 2274 |
| #45 | (adrenergic near/3 (antagonist* or block*)) in Trials | 6430 |
| #46 | betablocker* or beta‐blocker* in Trials | 3811 |
| #47 | beta* near/3 block in Trials | 2354 |
| #48 | (acebutolol or atenolol or Tenormin or alprenolol or betaxolol or bisoprolol or bupranolol or carvedilol or Coreg or carteolol or celiprolol or esmolol or labetalol or Normodyne or Trandate or metoprolol or nadolol or nebivolol or oxprenolol or penbutolol or pindolol or Visken or practolol or propranolol or Inderal or sotalol or timolol) in Trials | 12740 |
| #49 | #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 | 47745 |
| #50 | #30 and #49 in Trials | 5160 |
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.
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.
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.
Comparison 1 ACE inhibitors versus placebo, Outcome 1 Cardiovascular events.
Comparison 1 ACE inhibitors versus placebo, Outcome 2 Claudication distance.
Comparison 1 ACE inhibitors versus placebo, Outcome 3 Maximum walking distance.
Comparison 1 ACE inhibitors versus placebo, Outcome 4 Ankle brachial pressure index.
Comparison 2 Calcium antagonists versus placebo, Outcome 1 Degree of diameter stenosis.
Comparison 2 Calcium antagonists versus placebo, Outcome 2 Ankle brachial pressure index.
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).
| Study | Telmisartan (n = 18) | Placebo (n = 18) |
| Zankl 2010 | Median (95% CI) | Median (95% CI) |
| Zankl 2010 | 191 (157 ‐ 226) | 132 (103 ‐ 192) |
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) |
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) |
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.
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.
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.
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.
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.
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.
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.
| 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 | |
| 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 | |
| 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 | |
| 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 | ||
| 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 | |
| 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 | |
| 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 | |
