| Purpose:The relative effectiveness of two combination therapy-Renin Angiotensin System (RAS) blockades/Calcium Channel Blockers (CCBs) versus RAS blockades/diuretics for lowering blood pressure is unknown. This systematic review is to compare the benefits and harms of RAS blockades plus CCBs versus RAS blockades plus diuretics for treating essential hypertension in adults.Methods:We retrieved MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE and SCI using computers to identify relevant randomized controlled trials in English that directly compared the effect of RAS blockades plus CCBs with that of RAS blockades plus diuretics in adult patients with essential hypertension. reported an outcome of mean difference or interest of BP reduction, lasted at least 4 weeks, and included at least 20 patients. A standardized protocol with predefined criteria was used to extract data on study design, interventions, population characteristics, and outcomes; We evaluated the quality and applicability of included studies and assessed strength of the evidence for key outcomes.Results:Five clinical studies were eventually included. No significant difference was found between RAS blockades/CCBs with RAS blockades/diuretics in reduction of systolic and diastolic blood pressure (P=0.25, P=0.15). However, RAS blockades/CCBs associated with significant stronger DBP response rate (P=0.002). No differential effects were observed for the incidence of adverse events (P=0.47).Conclusion:Available evidence shows that RAS blockades/CCBs and RAS blockades/diuretics have similar effects on blood pressure control. High strength of evidence is needed. Data regarding in patient subgroups is missing. Purpose:The aim of this study is to review the available evidences about influences of essential hypertension and antihypertensive therapy on sexual function in hypertensive women.Methods:We retrieved MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE and SCI using the words "hypertension, sexual dysfunction, sexual function, female" to identify studies in English that included female hypertensive patients aged> 18 years, and reported the incidence of female sexual dysfunction, scores of female sexual function scales, changes in female sexual activity, sexual psychological or physical changes of femle patients. Types of studies included therapeutic research (randomized controlled trial, crossover study, historical control study, non-randomized controlled trial, descriptive study), cohort study, case-control study and cross-sectional survey.Results:Nine studies were eventually included. The types of researchs, interventions and indicators were not uniform. There are three therapeutic researchs. including two randomized controlled trials and one randomized crossover trial. There are six non-therapeutic researchs, of which four are cross-sectional studies, two are prospective cohort studies. Results of these studies are consistent in the relationships between hypertension and female sexual function. Hypertension could be considered risk factors for women suffering from hypertension. Evidences regarding impacts of antihypertensive drugs on female sexual function were not enough to draw conclusions. Present evidences indicated that (3-blockers may be related with the decline in female sexuality. ARB,on the other hand, seemed have no negative effects on female sexual function.Conclusion:Available evidences regarding impacts of hypertention and antihypertensive drugs on sexual function in hypertensive women are insufficient. Objectives:The aim of this study was to evaluate the impacts of felodipine plus irbesartan on sexual function compared with felodipine plus metoprolol in hypertensive women.Methods:Total of 160 women, aged 18-60 years, with newly diagnosed, previously untreated no less than one month, mild or moderate hypertension (systolic blood pressure[SBP]≥140 mm Hg and＜180 mm Hg, and/or diastolic blood pressure [DBP]≥90 mm Hg and＜110 mm Hg) were randomized to a treatment with felodipine 5-10mg+irbesartan150 mg once daily(n=80),or felodipine 5-10 mg+ metoprolol 47.5 mg once daily(n=80) for 48 weeks.141 patients completed the study. At baseline,24 weeks and 48 weeks, patients'sexual function was evaluated using a female sexual function index (FSFT) questionnaire. Levels of serum estradiol. testosterone,8-Hydroxy-2'-deoxyguanosine (8-OHdG),4-hydroxynonenal (HNE) and malondialdehyde (MDA) were measured in the meantime.Results:Combination regimens were similarly effective in lowing BP. In felodipine-irbesartan group, total scores of FSFI improved at 24 weeks and 48 weeks(P=0.006, P=0.001).Items showed improvement in scores correspond to desire and arousal(P=0.000, P=0.000) at 24 weeks. Scores for satisfaction increased at 48 weeks(P=0.048).In felodipine-metoprolol group, total scores for FSFI had no change compared with baseline at 24 weeks and 48 weeks(P=0.049, P=0.343). Level of serum estradiol increased under treatment with felodipine-irbesartan at 24 weeks and 48 weeks (P=0.001, P=0.003), and decreased under felodipine-irbesartan treatment (P=0.000. P=0.000). concentration of testosterone elevated under treatment with felodipine-irbesartan(P=0.000, P=0.000),and declined under felodipine-irbesartan treatment (P=0.000,P=0.000). In felodipine-irbesartan group, a decrease of serum 8-OHdG was observed after 24-week and 48-week treatment (P=0.001,P=0.000), as well as serum HNE (P=0.001.P=0.000) and serum MDA (P=0.000. P=0.000). In felodipine-metoprolol group, no significant change in level of serum 8-OHdG was observed at 24 weeks and 48 weeks (P=0.131, P=0.115).However, decrease of serum HNE and MDA was observed at 24 weeks (P=0.015,P=0.000) as well as 48 weeks (P=0.037, P=0.000). Felodipine-irbesartan combination resulted in better outcomes in oxidative stress. The differences in changes in 8-OHdG, HNE and MDA between groups were significant (P<0.05).Conclution:These results suggest that felodipine-irbesartan combination regiment improves sexual function in hypertensive women.Reasons for the different influences of these two combination regimens on female sexual function might be their different impacts on oxidative stress and hormone levels.
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