Application Of Network Meta-analysis Model To Study Different CCB Antihypertensive Drugs Primary Prevention Of Stroke

Objective:Network meta analysis model was used to evaluate the efficacy and safety of different ccb antihypertensive drugs for primary prevention of stroke in patients with hypertension.At the same time,the effectiveness and adverse reactions of different ccb antihypertensive drugs were ranked.The best treatment regimen was obtained to provide evidence-based medical evidence for clinical choice of drug use.Methods:Through a computer-based comprehensive search of PubMed,Embase,Cochrane Library,(CNKI),Wanfang,Chinese Biomedical(CBM)and other literature databases,the RCT and related systematic evaluation of different CCB antihypertensive drugs for the prevention of ischemic stroke were searched.The searching time was from the construction of the library to 2019.The language of the selected literature was limited to English and Chinese,and the related clinical data such as magazines,periodicals,conference abstracts and so on were searched manually.Upon completion of the search results,all the retrieved documents were independently screened and incorporated according to the results of the search by two professional researchers.At the same time,the quality evaluation of the final adopted literature research is carried out.In the end,the Stata13.0 software can be used to produce the network map of direct comparison of different intervention measures.Bayesian model was adopted and GeMTC 1.4.3 softwarewas used to carry out the network Meta analysis of the included literature research,and the results were outputted.Results:9 RCTs involving 36052 patients were included.The results of network Meta analysis showed that amlodipine [OR = 0.54 95%CI(0.25,1.29)] and felodipine [OR = 0.70 95%CI(0.41,1.21)] were effective in preventing stroke.Nifedipine [OR = 0.69 95%CI(0.46,0.93)],nisoldipine [OR=0.64 95%CI(0.14,2.24)] and nitrendipine [OR = 0.63 95%CI(0.45,0.90)] were significantly different from placebo control.Among them,nitrendipine and nifedipine had statistical differences in reducing the incidence of stroke,while the other CCB antihypertensive drugs had no statistical difference in reducing the incidence of stroke,but there were clinical differences.These results suggest that different CCB antihypertensive drugs can effectively reduce the incidence of stroke.In terms of the efficacy of different CCB antihypertensive drugs in reducing the incidence of stroke,amlodipine and felodipine [OR = 0.79 95 CI(0.30,2.07)],nifedipine [OR = 0.80 95% CI(0.35,2.09)],Nisoldipine [OR = 0.87 95% CI(0.21,4.56)],nitrendipine [OR = 0.86 95% CI(0.37,2.19)],felodipine and nifedipine [OR = 1.02 95% CI(0.56,2.10)],Nisoldipine [OR= 1.08 95% CI(0.29,5.31)],nitrendipine [OR = 1.11 95% CI(0.58,2.14)],nifedipine and nisoldipine [OR = 1.05 95% CI(0.294.84)],Nitrendipine [OR = 1.09 95% CI(0.62,1.70)],nisodipine and nitrendipine [OR = 1.02 95% CI(0.22,3.60)],amlodipine was less than 1when compared with other CCB antihypertensive drugs.The results suggest that amlodipine may be superior to other CCB antihypertensive drugs in reducing the incidence of stroke,but amlodipine,felodipine,nifedipine,nisoldipine,There was no significant difference in the effectiveness of nitrendipine in the prevention of stroke,and there was no significant difference in the effectiveness of different CCB antihypertensive drugs in the prevention of stroke in hypertensive patients.Conclusion:For the primary prevention of stroke with different ccb antihypertensive drugs,amlodipine should be considered firstly.However,there was no significant difference in the effectiveness of different types of CCB antihypertensive drugs in preventing stroke.Different kinds of CCB antihypertensive drugs were used to prevent stroke in economic strength and drug tolerance.Future studies need to improve large-scale,multicenter,high-quality randomized controlled clinical trials of various interventions,with a view to perfecting and developing the best program for primary stroke prevention in patients with hypertension.Thus,the survival ability and quality of life of patients can be improved,and the incidence and disability rate of stroke will be reduced.