Protective effect of valsartan versus amlodipine on left ventricular hypertrophy in patients with essential hypertension﹕a systematic review

Abstract:

Objective：To evaluate the protective effect and safety of valsartan on left ventricular hypertrophy（LVH） in patients with essential hypertension. Methods：Database was retrieved including The Cochrane Library，Ovid，Pubmed，Medline，Embase，CBM，CNKI，VIP and Wan Fang（by the end of December 2012）. Relevant magazines were retrieved manually. Baidu，Google and other re－sources on the internet were used for references. Simple evaluation method was recommended by the Cochrane Collaboration and two reviewers independently evaluated and cross-checked the quality of the included studies. Studies were screened according to prede－fined inclusion and exclusion criteria and the methodological quality was critically evaluated. Data analysis was conducted using RevMan 5.2 software. Results：A total of 291 papers were retrieved，7（6 Chinese and 1 English papers） randomized controlled trials（RCTs） were finally included. Meta analyses showed that：①effective rate：there was no difference in lowing systolic blood pressure（SBP） and diastolic blood pressure（DBP） between the valsartan group and amlodipine group，however，there were statistical differences in reversing LVH between the valsartan group and amlodipine group with better effect in valsartan group（MD=12.10，95%CI＝6.61 to 17.60，P=0.000）. ②incidence of adverse events：there was no significant difference in incidence of adverse events between valsartan group and amlodipine group（OR=0.54，95%CI=0.25 to 1.16，P=0.120）. Conclusions：Valsartan is superior to the amlodipine in the treatment of LVH of hypertension. Because of the small sample，low methodological quality and lack of experimental research on clinical events，it is necessary to conduct more large-scale，high-quality and multicenter RCTs in the future.