on November 5, 2009
Published online before print November 5, 2009, doi: 10.1161/STROKEAHA.109.559989
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Submitted on June 10, 2009
From the Department of Pharmacology (G.-C.L.), School of Pharmacy, Second Military Medical University, Shanghai, China, and the Center for New Drug Evaluation, Institute of Basic Medical Science, Second Military Medical University, Shanghai, China; Shanghai Changzheng Hospital (J.-W.C.), Second Military Medical University, Shanghai, China; the Department of Anesthesiology and Intensive Care (K.-M.Z.), Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China; and the Department of Pharmacology (X.-J.M., F.-M.S., D.-F.S.), School of Pharmacy, Second Military Medical University, Shanghai, China. * To whom correspondence should be addressed. E-mail: dfsu2008{at}gmail.com.
Background and Purpose—Angiotensin receptor blockers are widely used in patients at high risk of cardiocerebrovascular events. The aim of this meta-analysis was to investigate the effects of angiotensin receptor blockers on the risk of stroke. Methods—Electronic searches of MEDLINE, EMBASE, and the Cochrane central register of controlled trials were performed. A total of 20 randomized clinical trials with 108 286 patients reporting stroke were available for this clinical outcome analysis. Results—Angiotensin receptor blockers were associated with a significant reduction in the risk of stroke than placebo with an OR of 0.91 (0.84 to 0.98). Angiotensin receptor blockers were associated with no significant reduction in the risk of stroke compared with angiotensin-converting enzyme inhibitors (OR, 0.93; 0.84 to 1.03) and calcium antagonists (OR, 1.16; 0.91 to 1.48). Conclusions—Evidence of the benefit of angiotensin receptor blockers on the risk of stroke is provided when compared with placebo. There was no evidence of the benefit when comparing angiotensin receptor blockers with angiotensin-converting enzyme inhibitors and with calcium antagonists.
Accepted on June 25, 2009
A Systematic Review of Angiotensin Receptor Blockers in Preventing Stroke
Guo-Cai Lu MD;
Key words: angiotensin II type 1 receptor blockers • meta-analysis • stroke