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Blood pressure targets for the treatment of people with hypertension and cardiovascular disease
CONCLUSIONS: We found there is probably little to no difference in total mortality and cardiovascular mortality between people with hypertension and cardiovascular disease treated to a lower compared to a standard blood pressure target. There may also be little to no difference in serious adverse events or total cardiovascular events. This suggests that no net health benefit is derived from a lower systolic blood pressure target. We found very limited evidence on withdrawals due to adverse effects, which led to high uncertainty. At present, evidence is insufficient to justify lower blood pressure targets (135/85 mmHg or le...
Source: Cochrane Database of Systematic Reviews - November 18, 2022 Category: General Medicine Authors: Luis Carlos Saiz Javier Gorricho Javier Garj ón M ª Concepción Celaya Juan Erviti Leire Leache Source Type: research

Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease
CONCLUSIONS: HIF stabiliser management of anaemia had uncertain effects on CV death, fatigue, death (any cause), CV outcomes, and kidney failure compared to placebo or ESAs. Compared to placebo or ESAs, HIF stabiliser management of anaemia probably decreased the proportion of patients requiring blood transfusions, and probably increased the proportion of patients reaching the target Hb when compared to placebo.PMID:36005278 | DOI:10.1002/14651858.CD013751.pub2
Source: Cochrane Database of Systematic Reviews - August 25, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Allison Jaure Elisabeth M Hodson Marinella Ruospo Tess E Cooper Deirdre Hahn Valeria M Saglimbene Jonathan C Craig Giovanni Fm Strippoli Source Type: research

Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women
CONCLUSIONS: When compared to regular salt, LSSS probably reduce blood pressure, non-fatal cardiovascular events and cardiovascular mortality slightly in adults. However, LSSS also probably increase blood potassium slightly in adults. These small effects may be important when LSSS interventions are implemented at the population level. Evidence is limited for adults without elevated blood pressure, and there is a lack of evidence in pregnant women and people in whom an increased potassium intake is known to be potentially harmful, limiting conclusions on the safety of LSSS in the general population. We also cannot draw firm...
Source: Cochrane Database of Systematic Reviews - August 9, 2022 Category: General Medicine Authors: Amanda Brand Marianne E Visser Anel Schoonees Celeste E Naude Source Type: research

Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
CONCLUSIONS: This Cochrane Review provides low- to moderate-certainty evidence indicating that there are no significant differences in either short- or long-term risks of stroke, death, or TIA between people with symptomatic vertebral artery stenosis treated with ET plus MT and those treated with MT alone.PMID:35579383 | DOI:10.1002/14651858.CD013692.pub2
Source: Cochrane Database of Systematic Reviews - May 17, 2022 Category: General Medicine Authors: Ran Xu Xiao Zhang Sihua Liu Xue Wang Wenjiao Wang Kun Yang Tao Wang Adam A Dmytriw Xuesong Bai Yan Ma Liqun Jiao Bin Yang Source Type: research

Calcium supplementation for prevention of primary hypertension
CONCLUSIONS: An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-pow...
Source: Cochrane Database of Systematic Reviews - January 11, 2022 Category: General Medicine Authors: Gabriela Cormick Agust ín Ciapponi Mar ía Luisa Cafferata Mar ía Sol Cormick Jos é M Belizán Source Type: research

Calcium channel blockers versus other classes of drugs for hypertension
CONCLUSIONS: For the treatment of hypertension, there is moderate certainty evidence that diuretics reduce major cardiovascular events and congestive heart failure more than CCBs. There is low to moderate certainty evidence that CCBs probably reduce major cardiovascular events more than beta-blockers. There is low to moderate certainty evidence that CCBs reduced stroke when compared to angiotensin-converting enzyme (ACE) inhibitors and reduced myocardial infarction when compared to angiotensin receptor blockers (ARBs), but increased congestive heart failure when compared to ACE inhibitors and ARBs. Many of the differences ...
Source: Cochrane Database of Systematic Reviews - January 9, 2022 Category: General Medicine Authors: Jiaying Zhu Ning Chen Muke Zhou Jian Guo Cairong Zhu Jie Zhou Mengmeng Ma Li He Source Type: research

Roselle for hypertension in adults
CONCLUSIONS: The evidence is currently insufficient to determine the effectiveness of Roselle compared to placebo for controlling or lowering blood pressure in people with hypertension. The certainty of evidence was very low due to methodological limitations, imprecision, and indirectness. There is a need for rigorous RCTs that address the review question.PMID:34837382 | DOI:10.1002/14651858.CD007894.pub3
Source: Cochrane Database of Systematic Reviews - November 27, 2021 Category: General Medicine Authors: Porjai Pattanittum Chetta Ngamjarus Fonthip Buttramee Charoonsak Somboonporn Source Type: research

Renal denervation for resistant hypertension
CONCLUSIONS: In patients with resistant hypertension, there is low-certainty evidence that renal denervation does not improve major cardiovascular outomes and renal function. Conversely, moderate-certainty evidence exists that it may improve 24h ABPM and diastolic office-measured BP. Future trials measuring patient-centred instead of surrogate outcomes, with longer follow-up periods, larger sample size and more standardised procedural methods are necessary to clarify the utility of this procedure in this population.PMID:34806762 | DOI:10.1002/14651858.CD011499.pub3
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Anna Pisano Luigi Francesco Iannone Antonio Leo Emilio Russo Giuseppe Coppolino Davide Bolignano Source Type: research

Interventions for altering blood pressure in people with acute subarachnoid haemorrhage
CONCLUSIONS: Based on the current evidence, there is a lack of information needed to confirm or reject minimally important intervention effects on patient-important outcomes for both induced hypertension and lowered blood pressure. There is an urgent need for trials assessing the effects of altering blood pressure in people with acute subarachnoid haemorrhage. Such trials should use the SPIRIT statement for their design and the CONSORT statement for their reporting. Moreover, such trials should use methods allowing for blinded altering of blood pressure and report on patient-important outcomes such as mortality, rebleeding...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Mathias Maagaard William K Karlsson Christian Ovesen Christian Gluud Janus C Jakobsen Source Type: research

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