Application Of Network Meta Analysis Model To Study Angiotensin Receptor Antagonist Primary Prevention Of Ischemic Stroke

Objective:Using network Meta analysis(network meta-analysis,NMA)to systematically evaluate the effectiveness of diferent angiotensin receptor antagonists(angiotensin receptor blocker,ARB)in primary stroke prevention in patients with essential hypertension,And the effectivceness of different kinds of ARB kinds of antihypertensive drugs for the first-level prevention of stroke was sorted,and the best clinical medication plan was obtained,which played a guiding role in clinical treatment.Methods:Through thesystem retrieval CNKI?Wanfang,Weipu,Chinese biomedical literature database and other Chinese and PubMed?Cochrane Library?Embese and other English databases,To collect a randomized controlled trial(Randomized Clinical Trial s,RCTs)of ARB different types of antihypertensive druga for primary stroke prevention in patients with essential hypertension published from Building database until March 2020,And then we use Endnote document managemeant tools to eliminate and repeat the collected documents,Then two independent reviewers screened the collected documents according to the pre-established inclusion exclusion criteria,and separately extracted and evaluated the information obtained from the final screening according to the pre-established literature information extraction form.The Stata15.1 software was used to analyze the information Meta the network and obtain the ranking of the primary prevention effectiveness of different kinds ARB antihypertensive drugs for stroke in patients with essential hypertension.Results:Eventually,12 studies involving 27271 patients were included in RCTs study,After a series of operations,such as information extraction,quality evaluation,data entry and statistical analysis,The results showed that in reducing the inddence of first stroke in patients with essential hypertension,losartan works better compared to valsartan(RR 0.59,95%CI 0.13-2.65),candesartan(RR 0.39,95%CI 0.08-1.81),irbesartan(RR 0.49,95%CI 0.02-10.79);valsartan works better compared to candesartan(RR 0.65,95%CI 0.12-3.61),irbesartan((RR 0.83,95%CI 0.03-19.83);irbesartan and candesartan(RR 0.78,95)Compared to irbesartan(CI 0.03-19.10%),irbesartan works better.But the results of comparison between the four ARB kinds of antihypertensive drugs were not statistically significant.Conclusion:Available evidence suggests that losartan should be considered first,followed by valsartan,irbesartan,and candesartan,for primary stroke prevention in patients with essential hypertension using different ARB types of antihypertensive drugs.however,in this study,the effectiveness of different types of antihypertensive drugs for stroke prevention was not statistically significant.The reasons for this analysis may be due to the small sample size of the included studies or the lack of direct comparison ARB different types of antibypertensive drugs.In the future,with the wide application of ARB types of antihypertensive drugs and the development of large and high-quality studies on ARB types of antihypertensive drugs,Expect to get a statistically significant comparison of the efectiveness of different types ARB antihypertensive drugs for primary prevention of stroke to guide clinical medication.