Table 12

GRADE summary table

StudiesDesignQualityConsistencyDirectnessSDSAPBDRPC
Outcome: Blood pressure control
50RCTs (1 nonrandomized controlled trial, 1 cohort study, 1 case-control)Confounded by additional treatments, dose escalationConsistent resultsDirect
Outcome: Mortality and major cardiovascular events
9RCTsNo serious limitationsConsistent resultsDirect+
Outcome: Morbidity/quality of life
4RCTsNo serious limitationsConsistent resultsDirect
Outcome: Safety (serious and overall adverse events, withdrawals due to adverse events)
7 – serious AEs
29 – overall AEs
24 – withdrawals due to AEs
RCTs (1 nonrandomized controlled trial; 1 case-control)Variation in study protocols and data reportingConsistent resultsDirect
Outcome: Specific adverse events
30RCTs (3 cohort studies)Variation in data reportingConsistent resultsDirect
Outcome: Persistence/adherence
17RCTs (9 cohort studies)Variation in data reportingConsistent resultsDirect
Outcome: Rate of use of a single agent for blood pressure control
22RCTs (2 cohort studies, 1 case-control)No serious flawsConsistent resultsDirect
Outcome: Lipid levels
12RCTs (1 case- control)No serious flawsInconsistent results between studies and between lipid parametersDirect
Outcome: Rates of progression to type 2 diabetes
0NANANANA+
Outcome: Markers of carbohydrate metabolism/diabetes control
13RCTs (1 nonrandomized controlled trial, 1 case-control)No serious flawsInconsistent results between head-to-head studies and placebo- controlled studiesDirect
Outcome: Measures of LV mass/function
8RCTs (1 nonrandomized controlled trial; 1 case-control)Poor quality studies; small sample sizesConsistent resultsDirect
Outcome: Measures of kidney disease
15 GFRRCTs (1 nonrandomized controlled trial, 1 cohort study, 1 case-control)Poor quality studies; different parameters measuredConsistent resultsDirect
10 proteinuriaInconsistent resultsDirect

Abbreviations: AE(s) = adverse event(s); DR = dose response; LV = left ventricular; PB = publication bias; PC = all plausible confounders would reduce the effect; RCT(s) = randomized controlled trial(s); SA = strong association (+ = very strong, ++ = extremely strong); SD = sparse data

From: 4, Summary and Discussion

Cover of Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension
Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension [Internet].
Comparative Effectiveness Reviews, No. 10.
Matchar DB, McCrory DC, Orlando LA, et al.

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