ReviewCureus2026
Effect of Antihypertensive Drug Classes on Stroke Prevention: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hypertension is the most common modifiable risk factor for stroke. However, whether different classes of antihypertensive drugs provide equal protection against stroke remains controversial. This review aimed to systematically compare the effects of various antihypertensive drug classes on stroke prevention through a contemporary meta-analysis of randomized controlled trials (RCTs). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus for studies published since January 2000. Eligible RCTs compared angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), or diuretics with another drug class or placebo and reported stroke incidence. Data were pooled using a random-effects model. Subgroup analyses were performed based on prevention type, baseline risk, and differences in achieved blood pressure. A total of 10 RCTs (N=180,342 participants) were included. The pooled meta-analysis showed no statistically significant difference in stroke risk among the drug classes (risk ratio (RR): 0.94; 95% confidence interval (CI): 0.83-1.05), although heterogeneity was substantial (I²=65%). Subgroup analyses revealed no effect modification by prevention type or baseline risk. However, studies with a moderate to significant between-group difference in systolic blood pressure (SBP) (>2 mmHg) demonstrated a substantial reduction in stroke risk (RR: 0.78; 95% CI: 0.71-0.85), whereas studies with a minimal difference (<2 mmHg) did not (RR: 1.02: 95% CI: 0.90-1.14; p for subgroup difference=0.001). No antihypertensive drug class was found to be superior for stroke prevention overall. The magnitude of achieved SBP reduction, rather than the drug class itself, appears to be the primary determinant of benefit.
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Registered trials
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.