Meta-analysis Of Benazepril Combined Nifedipine In The Treatment Of Elderly Patients With Hypertension

Objective: To retrieve randomized controlled trials of benazepril combined nifedipine in the treatment of elderly patients with hypertension.Meta-analysis of the indicators,marked effect rate,total effective rate,change of systolic pressure,change of diastolic pressure,adverse reaction were performed.Compare benazepril combined nifedipine with single drug benazepril or nifedipine of efficacy and safety in the treatment of elderly hypertension,guiding medication for elderly patients with hypertension.Methods: Search PubMed,Cochrane Library,CBM,CNKI,Wan Fang,VIP databases by computer.Retrieval time from database establishment to January 2018,included randomized controlled trials of benazepril combined nifedipine in the treatment of elderly patients with hypertension.At the same time,search literatures of relevant magazines and references about benazepril combined nifedipine by hand.Two researchers independently select the literature,reading the title and abstract of the literature,excluded literatures that are not related to the study.Read remainder literatures carefully,to decide include or exclude.To evaluate quality and extract date of the included studies,extracting of related data,the number of marked effect,effective and adverse reactions,change of systolic and diastolic pressure,Meta-analysis are performed using RevMan 5.3 software.Results: A total of 16 articles are included,1664 elderly patients with hypertension.There are 801 people in the combined group and 863 in the single drug group.After two groups of drug intervention,Meta-analysis results show that:(1)marked effect rate: 15 articles are included,combined group(n=711),single drug group(n=833),compared with the single drug group(OR=2.68,95%CI: 2.18?3.29,P<0.05),combined group is better in marked effect rate,and the difference is statistically significant.(2)total effective rate: 16 articles are included,combined group(n=801),single drug group(n=863),compared with the single drug group(OR=4.44,95%CI: 3.22?6.13,P<0.05),combined group is better in total effective rate,and the difference is statistically significant.(3)change of systolic pressure: 11 articles are included,combined group(n=511),single drug group(n=512),compared with the single drug group(MD=-12.51,95%CI:-18.77?-6.24,P<0.05),combined group has a greater reduction in systolic pressure,and the difference is statistically significant.(4)change of diastolic pressure: 11 articles are included,combined group(n=511),single drug group(n=512),compared with the single drug group(MD=-12.25,95%CI:-15.65?-8.85,P<0.05),combined group has a greater reduction in diastolic pressure,and the difference is statistically significant.(5)adverse reaction: 12 articles are included,combined group(n=616),single drug group(n=678),compared with the single drug group(OR=0.55,95%CI: 0.38?0.79,P<0.05),combined group has fewer adverse reactions,and the difference is statistically significant.(1)edema: 7 articles are included,combined group(n=393),single drug group(n=453),there is no statistically significant difference between the two groups(OR=0.65,95%CI: 0.29?1.45,P=0.29);(2)cough: 7 articles are included,combined group(n=305),single drug group(n=367),there is no statistically significant difference between the two groups(OR=0.65,95%CI: 0.29?1.45,P=0.29);(3)headache: 8 articles are included,combined group(n=435),single drug group(n=496),compared with the single drug group(OR=0.51,95%CI: 0.29?0.91,P=0.02),combined group has fewer headache reaction,and the difference is statistically significant;(4)facial flushing: 3 articles are included,combined group(n=137),single drug group(n=197),there is no statistically significant difference between the two groups(OR=0.71,95%CI: 0.17?2.99,P=0.64);(5)dizziness: 3 articles are included,combined group(n=133),single drug group(n=134),there is no statistically significant difference between the two groups(OR=0.45,95%CI: 0.10?2.04,P=0.30);(6)increased heart rate: 2 articles are included,combined group(n=126),single drug group(n=126),there is no statistically significant difference between the two groups(OR=0.26,95%CI: 0.04?1.63,P=0.15).Conclusion: The existing research results show that benazepril combined nifedipine has a significant efficacy in the treatment of elderly patients with hypertension.The combined use of medicine can achieve synergistic antihypertensive effect and good safety.It is worthy of promotion and application in the clinical practice.