Tratamiento de la hipertensión en la enfermedad vascular periférica
Información
- DOI:
- https://doi.org/10.1002/14651858.CD003075.pub3Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 04 diciembre 2013see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Vascular
- Copyright:
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- Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
DAL updated the review.
GYHL identified and checked papers for relevance, and checked and edited the text of the review.
Sources of support
Internal sources
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Sandwell & West Birmingham Hospitals NHS Trust, UK.
External sources
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Chief Scientist Office, Scottish Government Health Directorates, The Scottish Government, UK.
The PVD Group editorial base is supported by the Chief Scientist Office
Declarations of interest
DL has declared that she is in receipt of investigator‐initiated educational grants from Bayer Healthcare and Boehringer Ingelheim for studies not related to the topic of this review. She has also served on the speakers bureau for Boehringer Ingelheim, Bayer and BMS/Pfizer and received reimbursement of meeting expenses from Boehringer Ingelheim.
GYL has served as a consultant and board member and received meeting expenses from Bayer, Astellas, Merck, AstraZeneca, Sanofi, BMS/Pfizer, Biotronik, Portola and Boehringer Ingelheim; and served on the speakers bureau for Bayer, BMS/Pfizer, Boehringer Ingelheim, and Sanofi‐Aventis. GYL has also reported receiving funds for development of educational presentations from Bayer, Merck, Sanofi, and Boehringer Ingelheim.
Acknowledgements
The authors would like to thank the HOPE investigators for providing unpublished data relating to the number of PAD patients randomised to ramipril or placebo. In addition, the authors would like to thank Dr Cathryn Broderick of the Cochrane Peripheral Vascular Disease Group for her support and assistance with the update of this review.
Version history
| Published | Title | Stage | Authors | Version |
| 2013 Dec 04 | Treatment of hypertension in peripheral arterial disease | Review | Deirdre A Lane, Gregory YH Lip | |
| 2009 Oct 07 | Treatment of hypertension in peripheral arterial disease | Review | Deirdre A Lane, Gregory YH Lip | |
| 2009 Jul 08 | Treatment of hypertension in peripheral arterial disease | Review | Gregory YH Lip, Andrew J Makin | |
Differences between protocol and review
None
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Female; Humans; Male;
PICO
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 | |
