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Adverse Effects and Treatment Discontinuation of Blood Pressure-Lowering Drugs and Combinations: A Network Meta-Analysis - PubMed

2 hours ago
  • #Blood pressure-lowering drugs
  • #Treatment discontinuation
  • #Adverse effects
  • Network meta-analysis of 716 short-term trials with 159,362 participants assessed adverse effects and discontinuation of blood pressure-lowering drugs and combinations.
  • Treatment discontinuation due to adverse events was significantly higher with calcium channel blockers (OR 1.43), angiotensin-converting enzyme inhibitors plus CCBs (OR 1.46), and β-blockers plus thiazide diuretics (OR 1.58) compared to placebo.
  • ARB-containing regimens, especially ARB monotherapy (OR 0.73) and ARBs plus CCBs (OR 0.61), had significantly fewer treatment discontinuations than placebo, suggesting better tolerability and symptomatic improvement.
  • Combination therapies generally showed higher tolerability than monotherapies in terms of discontinuation due to adverse events, with some regimens outperforming placebo.
  • All regimens significantly increased dizziness, and all except CCBs significantly decreased headache compared to placebo, highlighting varied side effect profiles.
  • The findings, based on trial-level data and network meta-analysis assumptions, emphasize class- and regimen-specific tolerability but may not directly apply to individual patients.