Evidence map›Paper›PMID 32316917›Full record

SynthesisBMC cardiovascular disorders2020

Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials.

Yara Wanas, Rim Bashir, Nazmul Islam, Luis Furuya-Kanamori

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cardiovascular disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Yara WanasDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Rim BashirDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Nazmul IslamDepartment of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar. nislam@qu.edu.qa.
Luis Furuya-KanamoriDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Qatar University · QAAustralian National University · AU

Funding

Australian National Health and Medical Research Council Early Career Fellowships APP1158469
6 · The paper itself

Abstract

backgroundAngiotensin receptor blockers (ARBs) are commonly used as a treatment for many cardiovascular diseases, but their safety has been called into question. The VALUE trial found an increased risk of myocardial infarction in participants receiving ARBs compared to other antihypertensive. The aim of the meta-analysis was to synthetize the available evidence of randomised controlled trials (RCTs) and elucidate if ARBs increase the risk of cardiovascular events.

methodsA comprehensive search was conducted to identify RCTs that assessed the safety of ARBs. Titles and abstracts of all papers were independently screened by two authors. Data extraction and quality assessment were also performed independently. The relative risk (RR) of all-cause mortality, myocardial infarction, and stroke were pooled using the IVhet model. Multiple sensitivity analyses were conducted to assess the effect of ARBs by restricting the analysis to different participants' characteristics.

resultsForty-five RCTs comprising of 170,794 participants were included in the analysis. The pooled estimates revealed that ARBs do not increase the risk of all-cause mortality (RR 1.00; 95%CI 0.97-1.04), myocardial infarction (RR 1.01; 95%CI 0.96-1.06), and stroke (RR 0.92; 95%CI 0.83-1.01). The sensitivity analysis did not yield a particular group of patients at increased risk of cardiovascular events with ARBs. Risk of all-cause mortality and stroke decreased with ARB when the proportion of smokers in a population was < 25% (RR 0.91; 95%CI 0.84-0.98) and in females (RR 0.76; 95%CI 0.68-0.84), respectively.

conclusionsARBs do not increase the risk of major cardiovascular events and are safe for use in patients.

Indexed as

AdultAgedAngiotensin Receptor AntagonistsCardiovascular DiseasesFemaleHumansMaleMiddle AgedPatient SafetyRandomized Controlled Trials as TopicRenin-Angiotensin SystemRisk AssessmentRisk FactorsTreatment OutcomeAngiotensin Receptor AntagonistsAngiotensin receptor blockersCardiovascular eventsMeta-analysisRisk

Identifiers

PMID32316917
PMCPMC7175553
OpenAlexW3016325315

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.