Introduction
Methods
Design of this study
Literature retrieval
Selection criteria
Study selection
Data extraction
Geometry of the network plot
Risk of bias assessment
Statistical analysis
Results
Literature selection
Study characteristics
References | Race | Conditions | Regimes | Sample size | Age, years | BMI, kg/m2 | SBP, mmHg | DBP, mmHg | Duration |
---|---|---|---|---|---|---|---|---|---|
Williams et al. [16] | not restricted | mild-to-moderate essential hypertension | Sac/vals 200 mg/day | 229 | 68.2 ± 5.7 | 28.60 ± 4.47 | 160.4 ± 12.3 | 85.8 ± 8.6 | 52 weeks |
Olmesartan 20 mg/day | 225 | 67.2 ± 6.0 | 29.10 ± 4.90 | 160.8 ± 15.6 | 85.8 ± 8.6 | ||||
Izzo et al. [13] | not restricted | mild-to-moderate essential hypertension | Sac/vals 400 mg/day | 142 | 61.2 ± 10.6 | 29.30 ± 5.50 | 159.6 ± 7.0 | 90.9 ± 8.9 | 8 weeks |
Valsartan 320 mg/day | 143 | 62.0 ± 11.5 | 30.00 ± 5.30 | 160.0 ± 7.3 | 90.2 ± 9.4 | ||||
Wang et al. [12] | Asians | salt-sensitive hypertension | Sac/vals 400 mg/day | 36 | 55.7 ± 12.5 | 26.40 ± 3.80 | 147.0 ± 9.7 | 90.2 ± 6.9 | 4 weeks |
Valsartan 320mgday | 36 | 58.9 ± 7.5 | 25.70 ± 2.90 | 147.5 ± 12.1 | 90.4 ± 7.2 | ||||
Supasyndh et al. [19] | Asians | elderly Asian | Sac/vals 200 mg/day | 296 | 70.5 ± 4.7 | 24.30 ± 3.15 | 160.5 ± 8.4 | 84.6 ± 9.7 | 14 weeks |
Olmesartan 20 mg/day | 292 | 70.9 ± 4.7 | 24.60 ± 3.24 | 160.0 ± 8.0 | 85.2 ± 9.8 | ||||
Schmieder et al. [14] | not restricted | stage 1 and 2 essential hypertensions | Sac/vals 400 mg/day | 57 | 60.5 ± 7.8 | 28.10 ± 4.50 | 155.3 ± 9.0 | 92.7 ± 8.8 | 52 weeks |
Olmesartan 40 mg/day | 57 | 59.2 ± 13.1 | 28.60 ± 3.90 | 155.0 ± 9.1 | 91.7 ± 8.7 | ||||
Huo et al. [17] | Asians | mild-to-moderate essential hypertension | Sac/vals 200 mg/day | 479 | 57.5 ± 10.2 | 26.40 ± 3.91 | 158.0 ± 7.2 | 90.7 ± 9.4 | 8 weeks |
Sac/vals 400 mg/day | 472 | 58.0 ± 9.7 | 26.30 ± 3.56 | 157.9 ± 6.7 | 89.8 ± 9.5 | ||||
Olmesartan 20 mg/day | 484 | 57.4 ± 10.1 | 26.40 ± 3.92 | 158.0 ± 6.5 | 90.8 ± 9.6 | ||||
Cheung et al. [18] | not restricted | mild-to-moderate essential hypertension | Sac/vals 200 mg/day | 188 | 57.1 ± 10.2 | 30.50 ± 5.86 | 157.1 ± 9.5 | 90.4 ± 10.2 | 8 weeks |
Olmesartan 20 mg/day | 187 | 58.0 ± 9.1 | 30.60 ± 5.09 | 157.8 ± 10.2 | 91.2 ± 8.9 | ||||
Ruilope et al. [10] | not restricted | mild-to-moderate essential hypertension | Sac/vals 100 mg/day | 156 | 53.0 ± 10.4 | n.a | 154.9 ± 11.9 | 99.9 ± 3.6 | 8 weeks |
Sac/vals 200 mg/day | 169 | 54.0 ± 9.7 | n.a | 156.8 ± 12.0 | 99.9 ± 4.1 | ||||
Sac/vals 400 mg/day | 172 | 52.0 ± 10.9 | n.a | 156.3 ± 12.3 | 100.4 ± 4.1 | ||||
Valsartan 80 mg/day | 163 | 53.0 ± 9.6 | n.a | 154.8 ± 10.5 | 99.5 ± 4.1 | ||||
Valsartan 160 mg/day | 166 | 53.0 ± 9.7 | n.a | 155.3 ± 10.8 | 99.8 ± 4.4 | ||||
Valsartan 320 mg/day | 164 | 53.0 ± 10.1 | n.a | 156.0 ± 11.5 | 99.5 ± 3.6 | ||||
Rakugi et al. [42] | Asians | mild-to-moderate essential hypertension | Sac/vals 200 mg/day | 387 | 57.9 ± 10.9 | 25.4 ± 3.7 | 157.7 ± 6.9 | 94.3 ± 9.4 | 8 weeks |
Sac/vals 400 mg/day | 385 | 58.7 ± 10.5 | 25.3 ± 3.9 | 158.4 ± 7.3 | 94.8 ± 9.8 | ||||
Olmesartan 20 mg/day | 389 | 59.6 ± 10.5 | 25.6 ± 3.8 | 157.6 ± 6.8 | 93.8 ± 9.7 |
References | Regimes | msSBP | msDBP | maSBP | maDBP | AEs |
---|---|---|---|---|---|---|
Williams et al. [16] | Sac/Val 200 mg/day | − 13.7 ± 16.2 | − 5.9 ± 8.8 | − 13.3 ± 7.8 | − 7.4 ± 4.7 | 132 |
Olmesartan 20 mg/day | − 9.9 ± 16.5 | − 4.9 ± 8.8 | − 9.1 ± 7.9 | − 5.5 ± 4.6 | 121 | |
Izzo et al. [13] | Sac/Val 400 mg/day | − 21.9 ± 22.6 | − 9.7 ± 15.5 | 13.0 ± 6.7 | − 6.2 ± 4.2 | n.a |
Valsartan 320 mg/day | − 16.3 ± 22.2 | − 7.2 ± 13.2 | − 9.6 ± 6.9 | − 5.2 ± 4.2 | n.a | |
Wang et al. [12] | Sac/Val 400 mg/day | − 13.3 ± 13.2 | − 6.2 ± 8.4 | n.a | n.a | 12 |
Valsartan 320 mg/day | − 5.8 ± 14.0 | − 4.2 ± 9.3 | n.a | n.a | 12 | |
Supasyndh et al. [19] | Sac/Val 200 mg/day | − 22.7 ± 15.6 | − 8.6 ± 8.1 | − 14.2 ± 7.00 | − 7.00 ± 3.9 | 141 |
Olmesartan 20 mg/day | − 16.1 ± 15.7 | − 6.5 ± 8.2 | − 9.1 ± 7.0 | − 4.5 ± 3.9 | 113 | |
Schmieder et al. [14] | Sac/Val 400 mg/day | − 25.4 ± 12.5 | − 11.6 ± 8.8 | n.a | n.a | n.a |
Olmesartan 40 mg/day | − 22.8 ± 14.2 | − 11.5 ± 8.9 | n.a | n.a | n.a | |
Huo et al. [17] | Sac/Val 200 mg/day | − 20.5 ± 13.3 | − 8.1 ± 8.1 | − 12.1 ± 6.7 | − 6.4 ± 4.3 | 143 |
Sac/Val 400 mg/day | 21.7 ± 13.4 | − 8.8 ± 8.2 | − 12.8 ± 6.7 | − 6.5 ± 4.2 | 132 | |
Olmesartan 20 mg/day | − 18.2 ± 13.4 | − 6.9 ± 8.1 | − 10.3 ± 2.6 | − 5.6 ± 4.2 | 134 | |
Cheung et al. [18] | Sac/Val 200 mg/day | − 14.2 ± 17.6 | − 7.5 ± 9.6 | − 4.3 ± 7.8 | − 2.3 ± 5.0 | 44 |
Olmesartan 20 mg/day | − 10.0 ± 17.6 | − 4.5 ± 9.7 | − 1.1 ± 7.7 | − 0.4 ± 5.00 | 41 | |
Ruilope et al. [10] | Sac/Val 100 mg/day | − 6.0 ± 13.8 | − 3.2 ± 8.8 | − 7.8 ± 11.8 | − 3.8 ± 12.9 | 36 |
Sac/Val 200 mg/day | − 18.7 ± 14.3 | 12.9 ± 9.1 | − 11.5 ± 7.3 | − 6.8 ± 4.5 | 40 | |
Sac/Val 400 mg/day | − 20.2 ± 14.3 | − 13.6 ± 9.1 | 14.6 ± 7.5 | − 8.3 ± 5.2 | 50 | |
Valsartan 80 mg/day | − 4.7 ± 13.8 | − 2.4 ± 8.8 | − 7.2 ± 11.8 | − 4.8 ± 12.9 | 36 | |
Valsartan 160 mg/day | − 13.4 ± 14.3 | − 10.0 ± 9.1 | − 8.3 ± 7 | − 6.3 ± 4.9 | 34 | |
Valsartan 320 mg/day | − 14.2 ± 14.3 | − 10.9 ± 9.1 | − 9.4 ± 7.1 | − 7.1 ± 4.9 | 38 | |
Rakugi et al. [42] | Sac/Val 200 mg/day | − 18.2 ± 12.5 | − 9.5 ± 8.5 | n.a | n.a | 135 |
Sac/Val 400 mg/day | − 20.2 ± 13.5 | − 10.5 ± 9.7 | n.a | n.a | 136 | |
Olmesartan 20 mg/day | − 13.2 ± 15.3 | − 6.9 ± 9.8 | n.a | n.a | 152 |
Risk of bias
Meta-analysis of msSBP and msDBP
Comparison (continuous outcomes) | Number of patients | MD with 95%CI, mmHg |
---|---|---|
msSBP | ||
sac/vals*200 mg vs. sac/vals*100 mg | 1748 vs. 156 | − 21.46 (− 47.78 to 4.86) |
sac/vals*400 mg vs. sac/vals*100 mg | 1264 vs. 156 | − 8.44 (− 33.84 to 16.96) |
sac/vals*400 mg vs. sac/vals*200 mg | 1264 vs. 1748 | 13.02 (− 2.55 to 28.59) |
sac/vals*100 mg vs. Valsartan 80 mg | 156 vs. 163 | − 1.30 (− 30.71 to 28.11) |
sac/vals*200 mg vs. Olmesartan 20 mg | 1579 vs. 1577 | − 2.63 (− 15.50 to 10.24) |
sac/vals*200 mg vs. Valsartan 160 mg | 169 vs. 166 | − 14.06 (− 40.38 to 12.26) |
sac/vals*400 mg vs. Olmesartan 40 mg | 57 vs. 57 | − 2.59 (− 32.25 to 27.06) |
sac/vals*400 mg vs. Valsartan 320 mg | 350 vs. 343 | − 3.37 (− 19.92 to 13.17) |
msDBP | ||
sac/vals*200 mg vs. sac/vals*100 mg | 1748 vs. 156 | 5.93 (− 8.29 to 20.16) |
sac/vals*400 mg vs. sac/vals*100 mg | 1264 vs. 156 | − 3.45 (− 17.18 to 10.27) |
sac/vals*400 mg vs. sac/vals*200 mg | 1264 vs. 1748 | − 9.38 (− 17.79 to − 0.97) |
sac/vals*100 mg vs. Valsartan 80 mg | 156 vs. 163 | − 0.83 (− 16.72 to 15.06) |
sac/vals*200 mg vs. Olmesartan 20 mg | 1579 vs. 1577 | 0.04 (− 6.90 to 6.98) |
sac/vals*200 mg vs. Valsartan 160 mg | 169 vs. 166 | 12.69 (− 1.53 to 26.92) |
sac/vals*400 mg vs. Olmesartan 40 mg | 57 vs. 57 | − 0.10 (− 16.21 to 16.00) |
sac/vals*400 mg vs. Valsartan 320 mg | 350 vs. 343 | 1.10 (− 7.88 to 10.07) |
maSBP | ||
sac/vals*200 mg vs. sac/vals*100 mg | 1748 vs. 156 | − 3.70 (− 6.22 to − 1.18) |
sac/vals*400 mg vs. sac/vals*100 mg | 1264 vs. 156 | − 1.96 (− 5.08 to 1.16) |
sac/vals*400 mg vs. sac/vals*200 mg | 879 vs. 1361 | 1.74 (− 0.10 to 3.58) |
sac/vals*100 mg vs. Valsartan 80 mg | 156 vs. 163 | − 0.60 (− 3.50 to 2.30) |
sac/vals*200 mg vs. Olmesartan 20 mg | 1192 vs. 1188 | − 0.54 (− 3.29 to 2.22) |
sac/vals*200 mg vs. Valsartan 160 mg | 169 vs. 166 | − 3.23 (− 5.25 to − 1.21) |
sac/vals*400 mg vs. Olmesartan 40 mg | n.a | n.a |
sac/vals*400 mg vs. Valsartan 320 mg | 314 vs. 307 | − 0.34 (− 3.08 to 2.40) |
maDBP | ||
sac/vals*200 mg vs. sac/vals*100 mg | 1748 vs. 156 | − 2.98 (− 5.11 to − 0.85) |
sac/vals*400 mg vs. sac/vals*100 mg | 1264 vs. 156 | − 1.67 (− 3.91 to 0.57) |
sac/vals*400 mg vs. sac/vals*200 mg | 879 vs. 1361 | 1.31 (0.61 to 2.01) |
sac/vals*100 mg vs. Valsartan 80 mg | 156 vs. 163 | 1.00 (− 1.83 to 3.83) |
sac/vals*200 mg vs. Olmesartan 20 mg | 1192 vs. 1188 | 0.76 (− 1.42 to 2.94) |
sac/vals*200 mg vs. Valsartan 160 mg | 169 vs. 166 | − 0.53 (− 1.54 to 0.48) |
sac/vals*400 mg vs. Olmesartan 40 mg | n.a | n.a |
sac/vals*400 mg vs. Valsartan 320 mg | 314 vs. 307 | 1.66 (0.43 to 2.89) |
Comparison (dichotomous outcome) | Number of patients | OR with 95% CI |
---|---|---|
Trial-specified AEs | ||
sac/vals*200 mg vs. sac/vals*100 mg | 1748 vs. 156 | 1.03 (0.62–1.73) |
sac/vals*400 mg vs. sac/vals*100 mg | 1264 vs. 156 | 0.76 (0.42–1.38) |
sac/vals*400 mg vs. sac/vals*200 mg | 1264 vs. 1748 | 0.74 (0.55–0.99) |
sac/vals*100 mg vs. Valsartan 80 mg | 156 vs. 163 | 1.06 (0.63–1.79) |
sac/vals*200 mg vs. Olmesartan 20 mg | 1579 vs. 1577 | 1.22 (0.70–2.14) |
sac/vals*200 mg vs. Valsartan 160 mg | 169 vs. 166 | 1.20 (0.72–2.02) |
sac/vals*400 mg vs. Olmesartan 40 mg | n.a | n.a |
sac/vals*400 mg vs. Valsartan 320 mg | 208 vs. 200 | 0.76 (0.42–1.36) |