Effect and safety of losartan and captopril for the treatment of essential hypertension: A systematic review / 解放军医学杂志

ABSTRACT

Objective To assess the efficacy and safety of losartan and captopril for the treatment of essential hypertension.Methods The database was retrieved form China Journal Full-text Database(1994-2008.10),Chinese Biomedicine Database(1978-2008.10),Chinese Scientific Journals Full-text Database(1989-2008.10),WanFang database online(1982-2008.10),PubMed(1966-2008.10),Cochrane Library(Issue 4,2008),EMBASE(1900-2008.10),and SCI(1974-2008.10).Randomized control trials(RCTs) of losartan and captopril for essential hypertension were included.The methodological quality of included studies was assessed independently by two authors.The quality of the included studies was evaluated by Handbook 4.2.6 recommend standard.Data were analyzed by RevMan 4.2.10 from the Cochrane Collaboration.Results Eleven RCTs(including 1458 patients) met the inclusion criteria.① Treatment for 4 weeks There was a significant lowering of clinic systolic blood pressure(SBP) in losartan group compared with that in captopril group [WMD=0.59,95%CI(0.22~0.55),P=0.002];while no statistically significant difference existed between the two groups in clinic diastolic blood pressure(DBP) [WMD=-0.08,95%CI(-1.11~0.94),P=0.87].② Treatment for 8 weeks no significant difference was found between losartan group and captopril group in the lowering of clinic SBP [WMD=0.26,95%CI(-0.08~0.61),P=0.14] and DBP [WMD=0.13,95%CI(-0.28~0.54),P=0.54].③ Treatment for 12 weeks no statistically significant difference existed between the two groups in clinic SBP [WMD=1.75,95%CI(-0.22~3.72),P=0.08] and DBP [WMD=1.15,95%CI(-2.81~5.11),P=0.57].④ The side effect in losartan group was lower than that in captopril group [OR=0.55,95%CI(0.42~0.73),P=0.00].Conclusions Based on the review,losartan is more effective and safe in lowering SBP compared with captopril.Further high-quality randomized controlled trials are needed to provide reliable evidence on the treatment of patients with essential hypertension.