The Effects of Different Antihypertensive Drugs on Postmenopausal Mild-to-Moderate Hypertension: A Network Meta-analysis

Abstract Background To compare the effects of different antihypertensive drugs on the reduction of blood pressure in postmenopausal women with hypertension. Methods PubMed, EMBASE, Cochrane Library, ClinicalTrails, WanFang, VIP, and CNKI databases were electronically retrieved. The retrieval time limit was from the establishment of the database to April 2020. The efficacy of 2 or more antihypertensive agents or placebos in postmenopausal hypertensive females was investigated. Mainly, the changes of systolic and diastolic blood pressure were compared. Two reviewers independently screened the literature and extracted the data. Cochrane’s “risk of bias” method was used to evaluate the methodological quality of randomized controlled trials. A network meta-analysis was performed by Stata15.0 software. Results Eight studies were involved in this meta-analysis. Angiotensin receptor blockers (ARBs) showed the most significant antihypertensive effects on systolic blood pressure as compared with placebo [standardized mean differences (SMDs) = −9.25, 95% credibility intervals (CIs) −12.24 to −6.26]. Surface under the cumulative ranking (SUCRA) suggested ARB (SUCRA = 76.3%) and diuretics (SUCRA = 72.4%) was the cumulative probability of the best treatment. Diuretics showed the best effect on diastolic blood pressure (SMD = −11.98, 95% CI −14.42 to −0.95) and its cumulative probability was the highest (SUCRA = 94.9%). Conclusions For postmenopausal females with hypertension, ARB was optimal on systolic blood pressure while diuretics was optimal on diastolic blood pressure among the different antihypertensive drugs.