Antihypertensive pharmacotherapy for prevention of sudden cardiac death in hypertensive individuals

Taverny, Garry; Mimouni, Yanis; LeDigarcher, Anne; Chevalier, Philippe; Thijs, Lutgarde; Wright, James M; Gueyffier, François

doi:10.1002/14651858.cd011745.pub2

Cited by 18 publications

(19 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have established the benefits of antihypertensive drugs in reducing cardiovascular morbidity and mortality in patients with hypertension [26,27]. However, a recent systematic review in hypertensive patients found that antihypertensive drugs (mainly thiazide diuretics) did not reduce SCA risk (RR 0.96; 95%CI 0.81-1.15), although these drugs did significantly reduce nonfatal and fatal myocardial infarction (MI) compared to placebo or no treatment [28]. However, this study had the limitation that the cause of SCA was unknown.…”

Section: Figurementioning

confidence: 99%

The impact of serum potassium‐influencing antihypertensive drugs on the risk of out‐of‐hospital cardiac arrest: A case–control study

Alharbi

Souverein

Groot

et al. 2017

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

Section: Figurementioning

confidence: 99%

The impact of serum potassium‐influencing antihypertensive drugs on the risk of out‐of‐hospital cardiac arrest: A case–control study

Alharbi

Souverein

Groot

et al. 2017

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…However, there has been debate around whether these guidelines were supported by evidence [10]. The existing systematic reviews and meta-analyses have focused on the efficacy of blood-pressure lowering [5,[11][12][13][14] rather than long-term outcomes [15][16][17].The primary objective of the present review was to compare the efficacy of monotherapy with the thiazide diuretic bendroflumethiazide vs. the thiazide-like diuretic indapamide as a first line in the treatment of primary hypertension on mortality and cardiovascular outcomes. The secondary objective was to compare the effect of these two monotherapies on secondary outcomes such as BP lowering, the need for intensification of treatment and medication discontinuation.…”

mentioning

confidence: 98%

The effect of indapamide vs. bendroflumethiazide for primary hypertension: a systematic review

Macfarlane

Pigazzani

Flynn

et al. 2018

Brit J Clinical Pharma

View full text Add to dashboard Cite

The aims of the current review were to compare the efficacy of monotherapy with bendroflumethiazide vs. indapamide on mortality, cardiovascular outcomes, blood pressure, need for intensification of treatment and treatment withdrawal. Two authors independently screened the results of a literature search, assessed the risk of bias and extracted relevant data. Randomized clinical trials of hypertensive patients of at least a 1‐year duration were included. When there was disagreement, a third reviewer was consulted. Risk ratio (RR) and mean differences were used as measures of effect. Two trials comparing bendroflumethiazide against placebo, one comparing indapamide with placebo and three of short duration directly comparing indapamide and Bendroflumethiazide, were included. No statistically significant difference was found between indapamide and bendroflumethiazide for all deaths [RR 0.82; 95% confidence interval (CI) 0.57, 1.18], cardiovascular deaths (RR 0.82; 95% CI 0.55, 1.20), noncardiovascular deaths (0.81; 95% CI 0.54, 1.22), coronary events (RR 0.73; 95% CI 0.30, 1.79) or all cardiovascular events (RR 0.89; 95% CI 0.67, 1.18). Indapamide performed worse for stroke (RR 2.21; 95% CI 1.19, 4.11), even though a reduction in RR compared with placebo was observed in both groups. There was no statistically or clinically significant difference between indapamide and bendroflumethiazide in blood pressure reduction (mean absolute difference <1 mmHg). The present review highlights a lack of studies to answer the review question but also a lack of evidence of superiority of one drug over the other. Therefore, there is a clear need for new studies directly comparing the effect of these drugs on the outcomes of interest.

show abstract

“…However, previous studies did not focus on prevention of SCD by anti-hypertensive treatment. A recent comprehensive meta-analysis by Taverny et al[31] is the only meta-analysis, which focused on the SCD outcome. Strikingly, Taverny et al[31] showed that while HTN treatment reduces the incidence of fatal and non-fatal myocardial infarction (MI), antihypertensive drugs do NOT reduce the incidence of SCD.…”

mentioning

confidence: 99%

“…A recent comprehensive meta-analysis by Taverny et al[31] is the only meta-analysis, which focused on the SCD outcome. Strikingly, Taverny et al[31] showed that while HTN treatment reduces the incidence of fatal and non-fatal myocardial infarction (MI), antihypertensive drugs do NOT reduce the incidence of SCD. Taverny et al[31] included RCTs that compared first line antihypertensive drugs to placebo or control (no therapy).…”

mentioning

confidence: 99%

“…Strikingly, Taverny et al[31] showed that while HTN treatment reduces the incidence of fatal and non-fatal myocardial infarction (MI), antihypertensive drugs do NOT reduce the incidence of SCD. Taverny et al[31] included RCTs that compared first line antihypertensive drugs to placebo or control (no therapy). For successful primary prevention of SCD in HTN patients, it is crucial to characterize associations between BP response on treatment (visit-to-visit variability, degree of BP reduction) and electrophysiological substrate in order to understand causes of failure to reduce SCD incidence by antihypertensive drugs, and identify subgroup(s) of patients in whom BP reduction DOES reduce the incidence of SCD.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Risk stratification of sudden cardiac death in hypertension

Tereshchenko

Soliman

Davis

et al. 2017

Journal of Electrocardiology

View full text Add to dashboard Cite

In the United States, up to 450,000 people per year die suddenly; an average of 1 sudden death every 70 seconds. Strategies for preventing sudden cardiac death are urgently needed. Systemic arterial hypertension is a major risk factor for sudden cardiac death and the increasing burden of hypertension is a worldwide problem. The lifetime risk of sudden cardiac death at 30 years of age is higher by 30% in individuals with hypertension. Each 20/10 mm Hg increase in systolic/diastolic blood pressure, is associated with a 20% additional increase in sudden cardiac death risk. Theoretically, antihypertensive treatment should be an effective strategy for sudden cardiac death prevention. However, a recent meta-analysis of 15 randomized controlled trials showed that antihypertensive treatment does not reduce the incidence of sudden cardiac death. This manuscript reviews ECG predictors of sudden cardiac death and the importance of risk stratification for appropriate management of hypertension.

show abstract

Antihypertensive pharmacotherapy for prevention of sudden cardiac death in hypertensive individuals

Cited by 18 publications

References 68 publications

The impact of serum potassium‐influencing antihypertensive drugs on the risk of out‐of‐hospital cardiac arrest: A case–control study

The impact of serum potassium‐influencing antihypertensive drugs on the risk of out‐of‐hospital cardiac arrest: A case–control study

The effect of indapamide vs. bendroflumethiazide for primary hypertension: a systematic review

Risk stratification of sudden cardiac death in hypertension

Contact Info

Product

Resources

About