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The effect of indapamide vs. bendroflumethiazide for primary hypertension: a systematic review.
Macfarlane, Tatiana V; Pigazzani, Filippo; Flynn, Robert W V; MacDonald, Thomas M.
Afiliação
  • Macfarlane TV; Medicines Monitoring Unit (MEMO), School of Medicine, University of Dundee, Dundee, UK.
  • Pigazzani F; Medicines Monitoring Unit (MEMO), School of Medicine, University of Dundee, Dundee, UK.
  • Flynn RWV; Medicines Monitoring Unit (MEMO), School of Medicine, University of Dundee, Dundee, UK.
  • MacDonald TM; Medicines Monitoring Unit (MEMO), School of Medicine, University of Dundee, Dundee, UK.
Br J Clin Pharmacol ; 85(2): 285-303, 2019 02.
Article em En | MEDLINE | ID: mdl-30312512
ABSTRACT
The aims of the current review were to compare the efficacy of monotherapy with bendroflumethiazide vs. indapamide on mortality, cardiovascular outcomes, blood pressure, need for intensification of treatment and treatment withdrawal. Two authors independently screened the results of a literature search, assessed the risk of bias and extracted relevant data. Randomized clinical trials of hypertensive patients of at least a 1-year duration were included. When there was disagreement, a third reviewer was consulted. Risk ratio (RR) and mean differences were used as measures of effect. Two trials comparing bendroflumethiazide against placebo, one comparing indapamide with placebo and three of short duration directly comparing indapamide and Bendroflumethiazide, were included. No statistically significant difference was found between indapamide and bendroflumethiazide for all deaths [RR 0.82; 95% confidence interval (CI) 0.57, 1.18], cardiovascular deaths (RR 0.82; 95% CI 0.55, 1.20), noncardiovascular deaths (0.81; 95% CI 0.54, 1.22), coronary events (RR 0.73; 95% CI 0.30, 1.79) or all cardiovascular events (RR 0.89; 95% CI 0.67, 1.18). Indapamide performed worse for stroke (RR 2.21; 95% CI 1.19, 4.11), even though a reduction in RR compared with placebo was observed in both groups. There was no statistically or clinically significant difference between indapamide and bendroflumethiazide in blood pressure reduction (mean absolute difference <1 mmHg). The present review highlights a lack of studies to answer the review question but also a lack of evidence of superiority of one drug over the other. Therefore, there is a clear need for new studies directly comparing the effect of these drugs on the outcomes of interest.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bendroflumetiazida / Pressão Sanguínea / Diuréticos / Hipertensão / Indapamida Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bendroflumetiazida / Pressão Sanguínea / Diuréticos / Hipertensão / Indapamida Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2019 Tipo de documento: Article