Effect of aliskiren on cardiovascular outcomes in patients with prehypertension: a meta-analysis of randomized controlled trials

Abstract

Jing-Tao Zhang, Ke-Ping Chen, Ting Guan, Shu Zhang Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China Background: Aliskiren is a widely used therapy for patients with hypertension, however, the effect of aliskiren on major cardiovascular outcomes is a matter of debate. The aim of this study is to evaluate the effects of aliskiren therapy on major cardiovascular outcomes by this meta-analysis of randomized controlled trials. Methods: We searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials for relevant literature. All eligible studies were randomized controlled trials assessing the effect of aliskiren therapy compared with patients without aliskiren therapy. Relative risks (RRs) with 95% confidence intervals (CIs) were used to measure the effect of aliskiren therapy on major cardiovascular outcomes with a random-effect model. Results: We included six trials reporting data on 12,465 patients. These studies reported 1,886 occurrences of major cardiovascular events, 1,074 events of total mortality, 739 events of cardiac death, 366 events of myocardial infarction, and 319 events of stroke. Aliskiren therapy had no effect on major cardiovascular events (RR, 0.93; 95% CI: 0.77–1.13; P=0.47), total mortality (RR, 1.00; 95% CI: 0.77–1.29; P=1.00), cardiac death (RR, 1.01; 95% CI: 0.79–1.29; P=0.95), myocardial infarction (RR, 0.71; 95% CI: 0.36–1.38; P=0.31), or stroke (RR, 0.87; 95% CI: 0.48–1.58; P=0.64). Conclusion: Aliskiren therapy does not have an effect on the incidence of major cardiovascular events, total mortality, cardiac death, myocardial infarction, or stroke. Keywords: aliskiren, cardiovascular disease, stroke, systematic review, meta-analysis