The effect of diuretics in the prevention of stroke in patients with hypertension: A protocol for meta-analysis of randomised-controlled trials

Poster
2017 Cape Town [Global Evidence Summit]
pan J1, Ge L2, Yu J3, Zhang X3, Shi X4, Han X3
1The First Clinical Medical College of Lanzhou University, Lanzhou, 730000,China;School of Public health,Lanzhou university,Lanzhou,730000,China;Evidence-based Medicine Center of Lanzhou University, Lanzhou,730000, China
2The First Clinical Medical College of Lanzhou University, Lanzhou, 730000,China;Evidence-based Medicine Center of Lanzhou University, Lanzhou,730000, China
3The First Clinical Medical College of Lanzhou University, Lanzhou, 730000,China;School of Public health,Lanzhou university,Lanzhou,730000,China
4Gansu Rehabilitation Center Hospital, Lanzhou

Background:

Stroke is a leading health problem worldwide and an important cause of disability. Hypertension is a major risk factor for the development of stroke. It is well known that lowering blood pressure decreases the risk of stroke in people with moderate to severe hypertension. However,the specific effects of diuretics against of stoke in patients with hypertension as compared to no treatment and other antihypertensive drug classesare not known. Although many studies have investigated differences in the clinical efficacy of various drug classes for cause-specific outcomes, relatively few studies have compared different drug combinations. Because most patients need combination therapy, identification of the optimum combinations of therapies might be more clinically relevant than investigating the effectiveness of single therapies.

Objectives:

The aim of this study is to identify the effect of diuretics, other antihypertensive drug classes, placebo and different drug combinations for prevention of stroke.

Methods:

A systematic review of randomised-controlled trials that investigated the efficacy of diuertics aiming at improving blood pressure of stroke patients with hypertension will be conducted. Electronic searches will be performed in the PubMed, Excerpta Medica (EMBASE), Cocharane Library databases. Hand searches of the reference lists of the included studies or relevant reviews will also be employed.Two independent reviewers will screen all the retrieved titles, abstracts and full texts. A third reviewer will be referred to solve any disagreements. The Cochrane Risk-of-Bias Tool will be used to assess the quality of included studies. Meta-analysis will be performed, if the studies are sufficiently homogeneous. The primary outcome of the study is the incidence of stoke. We will perform a meta-analysis to compare the incidence of stroke of diuretics compared to no treatment and other antihypertensive drug classes by STATA 12.0. The quality of evidence will be assessed by GRADE.

Results and Conclusions:

This study is ongoing and results will be presented at the Summit as available.