Han Qi1, Zheng Liu1, Han Cao1, Wei-Ping Sun1,2, Wen-Juan Peng1, Bin Liu1, Sheng-Jie Dong3, Yu-Tao Xiang4, Ling Zhang1. 1. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. 2. Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China. 3. Department of Arthropathy, Yantai Yantaishan Hospital, Yantai, China. 4. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Abstract
BACKGROUND: Salt-sensitive hypertension (SSH) is an intermediate inherited phenotype of essential hypertension as well as being an independent risk factor for cardiovascular disease. However, effective medications for the treatment of SSH have not been clarified. This study was to compare the efficacious of different classes of antihypertensive agents combined with salt intake on the reduction of blood pressure (BP) in patients with SSH. METHODS: We used sources as PubMed, EMBASE, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), CNKI, and WANFANG database from inception to November 2016. Studies that compared the efficacy of 2 or more antihypertensive agents or placebos in adult salt-sensitive hypertensive patients were included. The outcomes included variations in mean arterial blood pressure, systolic and diastolic blood pressure. RESULTS: Twenty-five studies were involved in this meta-analysis. A calcium channel blocker (CCB) with hydrochlorothiazide and moderate salt intake was significantly the most efficacious in comparison with placebo (standardized mean differences (SMD), 95% credibility intervals (CI): 26.66, 12.60 to 40.16), angiotensin receptor blockers (ARBs) (SMD, 95% CI: 22.94, 5.26 to 40.51), and the other interventions for patients with SSH and no concomitant diseases. For SSH patients who were obese, CCB with metformin and moderate salt intake would decrease blood pressure with 17.90 mm Hg. CONCLUSIONS: For SSH patients with no concomitant diseases, CCB combined with hydrochlorothiazide and moderate salt intake was optimal in reducing BP, while CCB combined with metformin and moderate salt intake was the most efficacious at reducing BP in SSH patients with coexisting obesity.
BACKGROUND:Salt-sensitive hypertension (SSH) is an intermediate inherited phenotype of essential hypertension as well as being an independent risk factor for cardiovascular disease. However, effective medications for the treatment of SSH have not been clarified. This study was to compare the efficacious of different classes of antihypertensive agents combined with salt intake on the reduction of blood pressure (BP) in patients with SSH. METHODS: We used sources as PubMed, EMBASE, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), CNKI, and WANFANG database from inception to November 2016. Studies that compared the efficacy of 2 or more antihypertensive agents or placebos in adult salt-sensitive hypertensivepatients were included. The outcomes included variations in mean arterial blood pressure, systolic and diastolic blood pressure. RESULTS: Twenty-five studies were involved in this meta-analysis. A calcium channel blocker (CCB) with hydrochlorothiazide and moderate salt intake was significantly the most efficacious in comparison with placebo (standardized mean differences (SMD), 95% credibility intervals (CI): 26.66, 12.60 to 40.16), angiotensin receptor blockers (ARBs) (SMD, 95% CI: 22.94, 5.26 to 40.51), and the other interventions for patients with SSH and no concomitant diseases. For SSH patients who were obese, CCB with metformin and moderate salt intake would decrease blood pressure with 17.90 mm Hg. CONCLUSIONS: For SSH patients with no concomitant diseases, CCB combined with hydrochlorothiazide and moderate salt intake was optimal in reducing BP, while CCB combined with metformin and moderate salt intake was the most efficacious at reducing BP in SSH patients with coexisting obesity.
Authors: Iuliia Polina; Mark Domondon; Rebecca Fox; Anastasia V Sudarikova; Miguel Troncoso; Valeriia Y Vasileva; Yuliia Kashyrina; Monika Beck Gooz; Ryan S Schibalski; Kristine Y DeLeon-Pennell; Wayne R Fitzgibbon; Daria V Ilatovskaya Journal: Am J Physiol Renal Physiol Date: 2020-05-28
Authors: Daria V Ilatovskaya; Vladislav Levchenko; Kristen Winsor; Gregory R Blass; Denisha R Spires; Elizaveta Sarsenova; Iuliia Polina; Adrian Zietara; Mark Paterson; Alison J Kriegel; Alexander Staruschenko Journal: JCI Insight Date: 2022-05-09