Meta-Analysis Of Efficacy Of ACEI Vs. ARB In Treatment Of Proteinuria In Essential Hypertension

BackgroudKidney is one of the most primary and common target organs of essential hypertension, and urine protein excretion could be the reliable indicator of kidney damage in essential hypertension patients. It has been proved that angiotensin converting enzyme inhibitors (ACEI) and angiotension receptor blockers (ARB) can improve renal hemodynamic and decrease proteinuria excretion by affecting rennin-angiotensin-aldosterone system. This article investigated the efficacy of angiotensin-converting enzyme inhibitor (ACEI) vs. angiotensin receptor blocker (ARB) in the treatment of proteinuria in essential hypertension, to provide theory base for medical treatment to EH.ObjectiveTo compare the efficacy of angiotensin-converting enzyme inhibitor (ACEI) vs. angiotensin receptor blocker (ARB) in the treatment of proteinuria in essential hypertension.MethodsInclusion and exclusion criteria were laid down. Databases were searched, including Pubmed, Elsevier, CNKI and CBM during2001to2011.Trials about ACEI vs. ARB for proteinuria, including24hours urinary total protein excretion,24hours albumin excretion rate and microalbuminuria, in essential hypertension were included. Review Manager V5.0software was used for Meta-analysis. Adverse effects occurrence was roughly described.Results1. Basic situation of included studies:A total of19articles were included, of which13articles reported24hours urinary total protein excretion, and7articles involved24hours albumin excretion rate, in addition,4articles published microalbuminuria. Totally1242patients were enrolled in this meta-analysis, including622cases receiving ACEI and620cases receiving ARB.2. Jadad scores showed:Only1article for4points and2articles for3points, the rest16articles have2points.3. Meta analysis results:Compared with ACEI therapy, ARB significantly reduced24hours albumin excretion rate,24hours albumin excretion rate and microalbuminuria.4. Adverse effects occurrence:Patients in both ACEI group and ARB group had cough or dry cough, fatigue, dizziness, etc. However, adverse effects occurred more in ACEI group than ARB group.ConclusionARB is more efficient to reduce the proteinuria in essential hypertension, with less side effect, and so it is worthy of clinical use.