Amlodipine And Nifedipine Clinical Meta-analysis Of Randomized Controlled Trials

Objective:To evaluate the efficacy, safety and economic evaluation of amlodipine and nifedipine in hypertensive by using Cochrane Systematic Reviews, to provide evidence for the clinical use of medicines. For the screening of our country's antihypertensive essential medicines provide reference. At the same time, it is a useful attempt and exploration to use the Meta-analysis to evaluate the effectiveness of antihypertensive drugs.Methods:A comprehensive collection of amlodipine and nifedipine on the treatment of hypertension randomized control trials. Jadad scoring method used, the contents include:randomization, blinding, allocation concealment, attrition bias (exit or lost) and the baseline study, included in the study of the literature on quality assessment. Cochrane systematic reviews using the software Review Manager 5.0.25 in the literature of included for statistical analysis.Results:The paper met the inclusion criteria were 14. Meta-analysis showed that:①amlodipine and nifedipine in the treatment of hypertension in the total effective rate was statistically significant difference with P<0.05, combined OR=2.40, 95%CI= (1.72,3.34); heterogeneity with P>0.1 and I2<50%, prompted the research of homogeneity, using fixed effect model to calculate the combined statistics; combined OR values and their combined 95% CI does not void the forest map lines cross, and fell on the right side of ineffective line, suggesting that amlodipine group (test group) of the total effective than nifedipine group (control group); the total efficiency of the effect size OR value of the abscissa to SE (log (OR)) is the vertical axis drawn about the basic symmetrical funnel plot, Which suggesting the current study is still unable to believe that the information there is publication bias.②amlodipine and nifedipine in the treatment of hypertension were statistically significant differences in the efficiency with P<0.05, combined OR=1.80,95% CI= (1.39,2.33); heterogeneity with P> 0.1 and I2<50%, prompted the study homogeneous, the fixed effect model to calculate the combined statistics; OR values and their combined 95%CI does not void the forest graph lines cross, and fell on the right side of ineffective line, suggesting that amlodipine group was higher than the efficiency of nifedipine; to the effect of the total effective abscissa is the amount of OR to SE (log (OR)) is the vertical axis drawn about the basic symmetrical funnel plot, suggesting that the current study is still unable to believe that the information there is publication bias.③amlodipine treatment of hypertension showed no difference in efficiency and nifedipine with P> 0.05, combined OR=1.04,95%CI= (0.79,1.38); heterogeneity with P> 0.1 and I2<50%, similar studies suggest multiple homogeneous, the fixed effect model to calculate the combined statistics; OR and combined 95% CI and the lines cross the forest map is not valid, suggesting that amlodipine group the efficient and nifedipine group no significant difference; drawn about the basic symmetrical funnel plot, suggesting still unable to believe that the present existence of publication bias research data.④amlodipine and nifedipine treatment of hypertensive adverse events were statistically significant differences with P<0.05, combined OR=0.39,95%CI=(0.28,0.53); heterogeneity test P> 0.1, and I2<50%, prompted the study homogeneous, the fixed effect model to calculate the combined statistics; OR combination and 95% confidence interval does not void the forest graph lines cross, and fell on the left when the line is not valid, suggesting that amlodipine group (test group) the incidence of adverse events than nifedipine group (control group); incidence of adverse reactions to the effects of the amount of OR= abscissa to SE (log (OR)) is ordinate funnel plot asymmetry drawn, the current study data suggest there are some publication bias.⑤Pharmacoeconomic analysis showed that amlodipine was effective in cost-effective than nifedipine small; when the effective rate is 100%, the cost of amlodipine smaller than nifedipine, suggesting that amlodipine was the best treatment.Conclusion:The available clinical evidence suggests that the efficiency of amlodipine was significantly greater than the efficiency of nifedipine; amlodipine and nifedipine are effective and efficient non-discriminatory; amlodipine is greater than the total efficiency of nifedipine in the total efficiency; amlodipine is less than the incidence of adverse reactions nifedipine; amlodipine cost-effectiveness is less than nifedipine, amlodipine, compared between the two is the best treatment. With the incorporation of low-quality literature, needs further high-quality large-scale multi-center study.