Objective To assess the effectiveness and safety of irbesartan for hypertensive patients with hyperuricaemia. Methods The databases such as The Cochrane Library (Issue 2, 2010), MEDLINE (by the end of April 2010), SCI (by the end of April 2010), CBM (by the end of April 2010) and CNKI (by the end of April 2010) were searched to collected randomized controlled trails (RCTs) on irbesartan for hypertensive combined with hyperuricaemia. Studies were screened according to the inclusion and exclusion criteria; data were extracted; the methodological quality was evaluated; and meta-analyses were conducted by using RevMan 5.0.0 software. Results Nine studies involving 977 patients were included. The results of meta-analyses showed that compared with the control group, irbesartan was superior in decreasing serum uric acid (SUA) (MD=57.12, 95%CI 16.08 to 98.15, P=0.006); it was similar in controlling blood pressure (Systolic pressure: MD= –0.24, 95%CI –2.19 to 1.71, P=0.81; Diastolic pressure: MD=0.46, 95%CI –1.58 to 2.50, P=0.66), and lower in the incidence rate of adverse reaction (RR=0.07, 95%CI 0.02 to 0.24, P=0.000 1). Conclusion The study suggests that irbesartan is effective and safe to control blood pressure and decrease serum uric acid for hypertensive patients with hyperuricaemia. But because all nine included studies are graded C in quality, the conclusion still needs to be further verified by long-term, large scale and high quality studies.
ObjectiveTo explore the effect of irbesartan on patients with senile hypertension complicated with paroxysmal atrial fibrillation. MethodsA total of 126 inpatients and outpatients over 60 years of age with senile hypertension complicated with paroxysmal atrial fibrillation treated in our hospital from July 2010 to August 2012 were randomized into the study group (n=63, treated with irbesartan) and the control group (n=63, treated with amlodipine besylate). Diuretics was added according to blood pressure of the patients. All the patients were followed up for 12 months. Blood pressure control situation, atrial fibrillation recurrence frequency and duration time, alteration of left atrial inner diameter were compared between the two groups. ResultsThe level of blood pressure in both groups after treatment was significantly decreased compared with baseline, and there was no statistically significant difference in the decrease of blood pressure after treatment between the two groups (P>0.05). Atrial fibrillation recurrence frequency in the study group was (5.28±1.14) times, which was significantly lower than that in the control group[(9.24±1.34) times] (P<0.01). The paroxysmal atrial fibrillation duration time in the study group was (14.3±4.8) hours, which was significantly lower than that in the control group[(21.3±4.9) hours] (P<0.01). After treatment, the left atrial inner diameter in the study group was significantly diminished compared with that before treatment (P<0.01). ConclusionFor patients with senile hypertension complicated with paroxysmal atrial fibrillation, irbesartan is effective to control blood pressure, decrease atrial fibrillation recurrence frequency and duration, and inhibit left atrioventricular remodeling.
ObjectiveTo systematically review the efficacy of irbesartan combined with amiodarone versus amiodarone alone for paroxysmal atrial fibrillation. MethodsWe electronically searched databases including PubMed, CENTRAL, EMbase, VIP, CNKI and WanFang Data to collect randomized controlled trials (RCTs) about irbesartan combined with amiodarone versus amiodarone alone in the treatment of paroxysmal atrial fibrillation from 2000 to 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of nine studies involving 998 patients were included. The results of meta-analysis showed that:Compared with the amiodarone group, the left atrial diameter was smaller (MD=-1.49, 95% CI -1.82 to -1.15), and the maintenance rates of sinus rhythm were higher (OR=3.02, 95%CI 2.21 to 4.11) in the irbesartan plus amiodarone group after 12 months. ConclusionCurrent evidence indicates that the combination treatment of irbesartan and amiodarone for paroxysmal atrial fibrillation is better than amiodarone alone in delaying the enlargement of left atrial diameter, as well as the maintenance of sinus rhythm. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of irbesartan combined with metoprolol plus conventional treatment compared with single drug (irbesartan, metoprolol) plus conventional treatment or conventional treatment for elderly patients with severe heart failure.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on irbesartan combined with metoprolol in the treatment of elderly patients with severe heart failure from January 2009 to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Network meta-analysis was then performed using gemtc package of R software.ResultsA total of 58 RCTs involving 5 064 patients were included. The results of meta-analysis showed that the efficiency, left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) of combination group were significantly superior to single drug group.ConclusionsThe current evidence shows that under the premise of conventional treatment, the combination of irbesartan and metoprolol is more effective than irbesartan or metoprolol alone in the treatment of elderly patients with severe heart failure. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.