First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection
Background Thoracic aortic dissection (TAD) is a severe and often lethal complication in people with hypertension. Current practice in the treatment of chronic type B aortic dissections is the use of beta‐blockers as first‐line therapy to decrease aortic wall stress. Other antihypertensive medicatio...
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| Veröffentlicht in: | Cochrane database of systematic reviews 2014-02, Vol.2014 (2), p.CD010426-CD010426 |
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| container_title | Cochrane database of systematic reviews |
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| creator | Chan, Kenneth K Lai, Peggy Wright, James M Chan, Kenneth K |
| description | Background
Thoracic aortic dissection (TAD) is a severe and often lethal complication in people with hypertension. Current practice in the treatment of chronic type B aortic dissections is the use of beta‐blockers as first‐line therapy to decrease aortic wall stress. Other antihypertensive medications, such as calcium channel blockers (CCBs), angiotensin‐converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), have been suggested for the medical therapy of type B TAD.
Objectives
To assess the effects of first‐line beta‐blockers compared with other first‐line antihypertensive drug classes for treating chronic type B TAD.
Search methods
We searched the Database of s of Reviews of Effects (DARE) for related reviews. We searched the Hypertension Group Specialised Register (1946 to 26 January 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLINE (1946 to 24 January 2014), MEDLINE In‐Process, EMBASE (1974 to 24 January 2014) and ClinicalTrials.gov (to 26 January 2014).
Selection criteria
We considered randomized controlled trials (RCTs) comparing different antihypertensive medications in the treatment of chronic type B TAD to be eligible for inclusion. Total mortality rate was the primary outcome of this review. Secondary outcomes included total non‐fatal adverse events relating to TADs and number of people not requiring surgical treatment.
Data collection and analysis
Two review authors (KC, PL) independently reviewed titles and s and decided on studies to include based on the inclusion criteria. We resolved discrepancies between the two review authors by discussion.
Main results
After a thorough review of the search results, we identified no studies that met the inclusion criteria.
Authors' conclusions
We did not find any RCTs that compared first‐line beta‐blockers with other first‐line antihypertensive medications for the treatment of chronic type B TAD. Therefore, there is no RCT evidence to support the current guidelines recommending the use of beta‐blockers. RCTs are required to assess the benefits and harms of beta‐blockers and other antihypertensive medications as first‐line treatment of chronic type B TAD. |
| doi_str_mv | 10.1002/14651858.CD010426.pub2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10726980</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1504143614</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4922-701c679730b771db2e2a2cc1cfcaec7f0cb3d1ae7b6af645e95075200b34b1b83</originalsourceid><addsrcrecordid>eNqFUcFOGzEQtapWBdL-AvKxl4Sx12tnT6ikUJCQeoGzZTuzxLBZB9tJlRufwDfyJfUqBNFeerA91rx572keIccMJgyAnzAhazatp5PZD2AguJys1pZ_IIdDYzx0Pr6rD8hRSvcAlWy4-kwOuKgVMCYOycOFjym_PD13vkdqMZtS2y64B4yJbsq1TjTkBUZq-uwX2xXGjH3yG6RLnHtnsg99om2I1C1i6L2juYDoGTUh5vKb-5TQDagv5FNruoRfX98Rub04v5ldjq9__byafb8eO9FwPi7OnFSNqsAqxeaWIzfcOeZaZ9CpFpyt5sygstK0UtTY1KBqDmArYZmdViNyuuMtKykeHfY5mk6vol-auNXBeP13p_cLfRc2moHisplCYfj2yhDD4xpT1kufHHad6TGsk2Y1CCYqWc6IyB3UxZBSxPZNh4EeotL7qPQ-qkGdl8Hj9y7fxvbZFMDZDvDbd7jVLpT9Fv3_8P6j8gcNqamT</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504143614</pqid></control><display><type>article</type><title>First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection</title><source>MEDLINE</source><source>Cochrane Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Chan, Kenneth K ; Lai, Peggy ; Wright, James M ; Chan, Kenneth K</creator><creatorcontrib>Chan, Kenneth K ; Lai, Peggy ; Wright, James M ; Chan, Kenneth K</creatorcontrib><description>Background
Thoracic aortic dissection (TAD) is a severe and often lethal complication in people with hypertension. Current practice in the treatment of chronic type B aortic dissections is the use of beta‐blockers as first‐line therapy to decrease aortic wall stress. Other antihypertensive medications, such as calcium channel blockers (CCBs), angiotensin‐converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), have been suggested for the medical therapy of type B TAD.
Objectives
To assess the effects of first‐line beta‐blockers compared with other first‐line antihypertensive drug classes for treating chronic type B TAD.
Search methods
We searched the Database of s of Reviews of Effects (DARE) for related reviews. We searched the Hypertension Group Specialised Register (1946 to 26 January 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLINE (1946 to 24 January 2014), MEDLINE In‐Process, EMBASE (1974 to 24 January 2014) and ClinicalTrials.gov (to 26 January 2014).
Selection criteria
We considered randomized controlled trials (RCTs) comparing different antihypertensive medications in the treatment of chronic type B TAD to be eligible for inclusion. Total mortality rate was the primary outcome of this review. Secondary outcomes included total non‐fatal adverse events relating to TADs and number of people not requiring surgical treatment.
Data collection and analysis
Two review authors (KC, PL) independently reviewed titles and s and decided on studies to include based on the inclusion criteria. We resolved discrepancies between the two review authors by discussion.
Main results
After a thorough review of the search results, we identified no studies that met the inclusion criteria.
Authors' conclusions
We did not find any RCTs that compared first‐line beta‐blockers with other first‐line antihypertensive medications for the treatment of chronic type B TAD. Therefore, there is no RCT evidence to support the current guidelines recommending the use of beta‐blockers. RCTs are required to assess the benefits and harms of beta‐blockers and other antihypertensive medications as first‐line treatment of chronic type B TAD.</description><identifier>ISSN: 1465-1858</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD010426.pub2</identifier><identifier>PMID: 24570114</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Adrenergic beta‐Antagonists ; Antihypertensive Agents ; Antihypertensive Agents - therapeutic use ; Aortic Aneurysm, Thoracic ; Aortic Aneurysm, Thoracic - drug therapy ; Aortic Aneurysm, Thoracic - etiology ; Aortic Dissection ; Aortic Dissection - drug therapy ; Aortic Dissection - etiology ; Beta‐adrenergic blocking agents ; Heart & circulation ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - drug therapy ; Kidney disease ; Management of specific sub‐types of hypertensive patients ; Management/treatment of Specific sub‐types of Hypertensive Patients ; Medicine General & Introductory Medical Sciences ; Pharmacological Therapies ; Special Populations ; Treatment of essential Hypertension ; Treatment: pharmacological</subject><ispartof>Cochrane database of systematic reviews, 2014-02, Vol.2014 (2), p.CD010426-CD010426</ispartof><rights>Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4922-701c679730b771db2e2a2cc1cfcaec7f0cb3d1ae7b6af645e95075200b34b1b83</citedby><cites>FETCH-LOGICAL-c4922-701c679730b771db2e2a2cc1cfcaec7f0cb3d1ae7b6af645e95075200b34b1b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24570114$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Kenneth K</creatorcontrib><creatorcontrib>Lai, Peggy</creatorcontrib><creatorcontrib>Wright, James M</creatorcontrib><creatorcontrib>Chan, Kenneth K</creatorcontrib><title>First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Thoracic aortic dissection (TAD) is a severe and often lethal complication in people with hypertension. Current practice in the treatment of chronic type B aortic dissections is the use of beta‐blockers as first‐line therapy to decrease aortic wall stress. Other antihypertensive medications, such as calcium channel blockers (CCBs), angiotensin‐converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), have been suggested for the medical therapy of type B TAD.
Objectives
To assess the effects of first‐line beta‐blockers compared with other first‐line antihypertensive drug classes for treating chronic type B TAD.
Search methods
We searched the Database of s of Reviews of Effects (DARE) for related reviews. We searched the Hypertension Group Specialised Register (1946 to 26 January 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLINE (1946 to 24 January 2014), MEDLINE In‐Process, EMBASE (1974 to 24 January 2014) and ClinicalTrials.gov (to 26 January 2014).
Selection criteria
We considered randomized controlled trials (RCTs) comparing different antihypertensive medications in the treatment of chronic type B TAD to be eligible for inclusion. Total mortality rate was the primary outcome of this review. Secondary outcomes included total non‐fatal adverse events relating to TADs and number of people not requiring surgical treatment.
Data collection and analysis
Two review authors (KC, PL) independently reviewed titles and s and decided on studies to include based on the inclusion criteria. We resolved discrepancies between the two review authors by discussion.
Main results
After a thorough review of the search results, we identified no studies that met the inclusion criteria.
Authors' conclusions
We did not find any RCTs that compared first‐line beta‐blockers with other first‐line antihypertensive medications for the treatment of chronic type B TAD. Therefore, there is no RCT evidence to support the current guidelines recommending the use of beta‐blockers. RCTs are required to assess the benefits and harms of beta‐blockers and other antihypertensive medications as first‐line treatment of chronic type B TAD.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Adrenergic beta‐Antagonists</subject><subject>Antihypertensive Agents</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Aortic Aneurysm, Thoracic</subject><subject>Aortic Aneurysm, Thoracic - drug therapy</subject><subject>Aortic Aneurysm, Thoracic - etiology</subject><subject>Aortic Dissection</subject><subject>Aortic Dissection - drug therapy</subject><subject>Aortic Dissection - etiology</subject><subject>Beta‐adrenergic blocking agents</subject><subject>Heart & circulation</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - drug therapy</subject><subject>Kidney disease</subject><subject>Management of specific sub‐types of hypertensive patients</subject><subject>Management/treatment of Specific sub‐types of Hypertensive Patients</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Pharmacological Therapies</subject><subject>Special Populations</subject><subject>Treatment of essential Hypertension</subject><subject>Treatment: pharmacological</subject><issn>1465-1858</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFUcFOGzEQtapWBdL-AvKxl4Sx12tnT6ikUJCQeoGzZTuzxLBZB9tJlRufwDfyJfUqBNFeerA91rx572keIccMJgyAnzAhazatp5PZD2AguJys1pZ_IIdDYzx0Pr6rD8hRSvcAlWy4-kwOuKgVMCYOycOFjym_PD13vkdqMZtS2y64B4yJbsq1TjTkBUZq-uwX2xXGjH3yG6RLnHtnsg99om2I1C1i6L2juYDoGTUh5vKb-5TQDagv5FNruoRfX98Rub04v5ldjq9__byafb8eO9FwPi7OnFSNqsAqxeaWIzfcOeZaZ9CpFpyt5sygstK0UtTY1KBqDmArYZmdViNyuuMtKykeHfY5mk6vol-auNXBeP13p_cLfRc2moHisplCYfj2yhDD4xpT1kufHHad6TGsk2Y1CCYqWc6IyB3UxZBSxPZNh4EeotL7qPQ-qkGdl8Hj9y7fxvbZFMDZDvDbd7jVLpT9Fv3_8P6j8gcNqamT</recordid><startdate>20140226</startdate><enddate>20140226</enddate><creator>Chan, Kenneth K</creator><creator>Lai, Peggy</creator><creator>Wright, James M</creator><creator>Chan, Kenneth K</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140226</creationdate><title>First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection</title><author>Chan, Kenneth K ; Lai, Peggy ; Wright, James M ; Chan, Kenneth K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4922-701c679730b771db2e2a2cc1cfcaec7f0cb3d1ae7b6af645e95075200b34b1b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Adrenergic beta‐Antagonists</topic><topic>Antihypertensive Agents</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Aortic Aneurysm, Thoracic</topic><topic>Aortic Aneurysm, Thoracic - drug therapy</topic><topic>Aortic Aneurysm, Thoracic - etiology</topic><topic>Aortic Dissection</topic><topic>Aortic Dissection - drug therapy</topic><topic>Aortic Dissection - etiology</topic><topic>Beta‐adrenergic blocking agents</topic><topic>Heart & circulation</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - drug therapy</topic><topic>Kidney disease</topic><topic>Management of specific sub‐types of hypertensive patients</topic><topic>Management/treatment of Specific sub‐types of Hypertensive Patients</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Pharmacological Therapies</topic><topic>Special Populations</topic><topic>Treatment of essential Hypertension</topic><topic>Treatment: pharmacological</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Kenneth K</creatorcontrib><creatorcontrib>Lai, Peggy</creatorcontrib><creatorcontrib>Wright, James M</creatorcontrib><creatorcontrib>Chan, Kenneth K</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Kenneth K</au><au>Lai, Peggy</au><au>Wright, James M</au><au>Chan, Kenneth K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2014-02-26</date><risdate>2014</risdate><volume>2014</volume><issue>2</issue><spage>CD010426</spage><epage>CD010426</epage><pages>CD010426-CD010426</pages><issn>1465-1858</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Thoracic aortic dissection (TAD) is a severe and often lethal complication in people with hypertension. Current practice in the treatment of chronic type B aortic dissections is the use of beta‐blockers as first‐line therapy to decrease aortic wall stress. Other antihypertensive medications, such as calcium channel blockers (CCBs), angiotensin‐converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), have been suggested for the medical therapy of type B TAD.
Objectives
To assess the effects of first‐line beta‐blockers compared with other first‐line antihypertensive drug classes for treating chronic type B TAD.
Search methods
We searched the Database of s of Reviews of Effects (DARE) for related reviews. We searched the Hypertension Group Specialised Register (1946 to 26 January 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLINE (1946 to 24 January 2014), MEDLINE In‐Process, EMBASE (1974 to 24 January 2014) and ClinicalTrials.gov (to 26 January 2014).
Selection criteria
We considered randomized controlled trials (RCTs) comparing different antihypertensive medications in the treatment of chronic type B TAD to be eligible for inclusion. Total mortality rate was the primary outcome of this review. Secondary outcomes included total non‐fatal adverse events relating to TADs and number of people not requiring surgical treatment.
Data collection and analysis
Two review authors (KC, PL) independently reviewed titles and s and decided on studies to include based on the inclusion criteria. We resolved discrepancies between the two review authors by discussion.
Main results
After a thorough review of the search results, we identified no studies that met the inclusion criteria.
Authors' conclusions
We did not find any RCTs that compared first‐line beta‐blockers with other first‐line antihypertensive medications for the treatment of chronic type B TAD. Therefore, there is no RCT evidence to support the current guidelines recommending the use of beta‐blockers. RCTs are required to assess the benefits and harms of beta‐blockers and other antihypertensive medications as first‐line treatment of chronic type B TAD.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>24570114</pmid><doi>10.1002/14651858.CD010426.pub2</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Cochrane database of systematic reviews, 2014-02, Vol.2014 (2), p.CD010426-CD010426 |
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| language | eng |
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| source | MEDLINE; Cochrane Library; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adrenergic beta-Antagonists - therapeutic use Adrenergic beta‐Antagonists Antihypertensive Agents Antihypertensive Agents - therapeutic use Aortic Aneurysm, Thoracic Aortic Aneurysm, Thoracic - drug therapy Aortic Aneurysm, Thoracic - etiology Aortic Dissection Aortic Dissection - drug therapy Aortic Dissection - etiology Beta‐adrenergic blocking agents Heart & circulation Humans Hypertension Hypertension - complications Hypertension - drug therapy Kidney disease Management of specific sub‐types of hypertensive patients Management/treatment of Specific sub‐types of Hypertensive Patients Medicine General & Introductory Medical Sciences Pharmacological Therapies Special Populations Treatment of essential Hypertension Treatment: pharmacological |
| title | First‐line beta‐blockers versus other antihypertensive medications for chronic type B aortic dissection |
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