Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis
Background: Numerous clinical studies have demonstrated that the therapeutic efficacy of combining nifedipine and enalapril in treating hypertension with coronary heart disease surpasses that of nifedipine as a stand-alone treatment. However, the current evidence is not yet sufficient due to limitat...
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Society of Medical Biochemists of Serbia, Belgrade
2025-01-01
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| Series: | Journal of Medical Biochemistry |
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| Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582501001K.pdf |
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| author | Kun Wang Wenchao Ma Leina Sun Fangcheng Su |
| author_facet | Kun Wang Wenchao Ma Leina Sun Fangcheng Su |
| author_sort | Kun Wang |
| collection | DOAJ |
| description | Background: Numerous clinical studies have demonstrated that the therapeutic efficacy of combining nifedipine and enalapril in treating hypertension with coronary heart disease surpasses that of nifedipine as a stand-alone treatment. However, the current evidence is not yet sufficient due to limitations in the sample size, and further validation is needed. To analyze and assess the clinical impact of nifedipine combined with enalapril on hypertension complicated with coronary heart disease, and provide evidence for rational drug use in clinic. Methods: We employed a revised version of the Jadad scale to assess the quality of the research literature following a rigorous screening process. The statistical analysis was performed utilizing the software RevMan 5.4.1 for data analysis. Heterogeneity in the studies was evaluated based on the results of the Q test (P value), and the OR value of the combined effect was calculated using either the model with fixed effects or the one with random effects, with the results presented in a forest plot. Furthermore, a sensitivity analysis was conducted by excluding articles with the highest impact, and potential bias in publication was assessed through the utilization of a funnel plot. Results: A total of 183 articles were initially identified, and after a comprehensive review, 14 clinical randomized controlled trials were chosen for analysis. The meta-analysis findings revealed that the trial group displayed a significantly higher overall effectiveness rate compared to the control group (OR=3.47, 95%CI 2.40-5.03). Additionally, the trial group exhibited a more pronounced reduction in blood pressure and greater enhancement in cardiac function (OR=5.55, 95%CI). Conversely, the control group had a lower occurrence of ischemic events compared to the trial group (OR=0.35, 95%CI 0.24-0.50). Sensitivity analysis confirmed the stability and reliability of the combined effect size results (OR=3.91, 95%CI 2.51-6.09, P<0.00001). However, based on an assessment using funnel plot results suggested potential bias in publication. Conclusions: The combined administration of nifedipine and enalapril exhibits enhanced effectiveness compared to the sole use of nifedipine in individuals diagnosed with hypertension and coronary heart disease, rendering it a valuable alternative for clinical application. |
| format | Article |
| id | doaj-art-aa878739e26b4e16b4f973c11c5605c6 |
| institution | Kabale University |
| issn | 1452-8258 1452-8266 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Society of Medical Biochemists of Serbia, Belgrade |
| record_format | Article |
| series | Journal of Medical Biochemistry |
| spelling | doaj-art-aa878739e26b4e16b4f973c11c5605c62025-02-05T13:11:23ZengSociety of Medical Biochemists of Serbia, BelgradeJournal of Medical Biochemistry1452-82581452-82662025-01-0144111010.5937/jomb0-523871452-82582501001KMeta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysisKun Wang0Wenchao Ma1Leina Sun2Fangcheng Su3Weifang People's Hospital, Department of Respiratory and Critical Care Medicine, Weifang, ChinaWeifang People's Hospital, Department of Emergency, Weifang, ChinaWeifang People's Hospital, Department of Emergency, Weifang, ChinaWeifang People's Hospital, Department of Emergency, Weifang, ChinaBackground: Numerous clinical studies have demonstrated that the therapeutic efficacy of combining nifedipine and enalapril in treating hypertension with coronary heart disease surpasses that of nifedipine as a stand-alone treatment. However, the current evidence is not yet sufficient due to limitations in the sample size, and further validation is needed. To analyze and assess the clinical impact of nifedipine combined with enalapril on hypertension complicated with coronary heart disease, and provide evidence for rational drug use in clinic. Methods: We employed a revised version of the Jadad scale to assess the quality of the research literature following a rigorous screening process. The statistical analysis was performed utilizing the software RevMan 5.4.1 for data analysis. Heterogeneity in the studies was evaluated based on the results of the Q test (P value), and the OR value of the combined effect was calculated using either the model with fixed effects or the one with random effects, with the results presented in a forest plot. Furthermore, a sensitivity analysis was conducted by excluding articles with the highest impact, and potential bias in publication was assessed through the utilization of a funnel plot. Results: A total of 183 articles were initially identified, and after a comprehensive review, 14 clinical randomized controlled trials were chosen for analysis. The meta-analysis findings revealed that the trial group displayed a significantly higher overall effectiveness rate compared to the control group (OR=3.47, 95%CI 2.40-5.03). Additionally, the trial group exhibited a more pronounced reduction in blood pressure and greater enhancement in cardiac function (OR=5.55, 95%CI). Conversely, the control group had a lower occurrence of ischemic events compared to the trial group (OR=0.35, 95%CI 0.24-0.50). Sensitivity analysis confirmed the stability and reliability of the combined effect size results (OR=3.91, 95%CI 2.51-6.09, P<0.00001). However, based on an assessment using funnel plot results suggested potential bias in publication. Conclusions: The combined administration of nifedipine and enalapril exhibits enhanced effectiveness compared to the sole use of nifedipine in individuals diagnosed with hypertension and coronary heart disease, rendering it a valuable alternative for clinical application.https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582501001K.pdfnifedipineenalaprilhypertensioncoronary heart diseasemeta analysis |
| spellingShingle | Kun Wang Wenchao Ma Leina Sun Fangcheng Su Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis Journal of Medical Biochemistry nifedipine enalapril hypertension coronary heart disease meta analysis |
| title | Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis |
| title_full | Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis |
| title_fullStr | Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis |
| title_full_unstemmed | Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis |
| title_short | Meta-analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease: A systematic review and meta-analysis |
| title_sort | meta analysis of nifedipine and enalapril combination therapy for hypertensive patients with coronary heart disease a systematic review and meta analysis |
| topic | nifedipine enalapril hypertension coronary heart disease meta analysis |
| url | https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582501001K.pdf |
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