Abstract
Background. This study was intended to evaluate the efficacy and safety of Tongxinluo capsule for hypertension. Search Strategy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, The PubMed, EMBASE, Chinese Bio-Medical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database, and Wan-fang Data started from the first of database to October 28, 2013. No language restriction was applied. We included randomized clinical trials testing Tongxinluo capsule against western medicine, Tongxinluo capsule versus placebo, and Tongxinluo capsule combined with western medicine versus western medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 25 trials with 1958 participants were included. The methodological quality of the included trials was evaluated as generally low. The blood pressure (BP) lowering effect of Tongxinluo capsule plus western medicine was significantly higher than that of western medicine (systolic blood pressure (SBP): −3.87, −5.32 to −2.41, P < 0.00001; and diastolic blood pressure (DBP): −2.72, −4.19 to −1.24, P = 0.0003). The BP also decreased significantly from baseline with Tongxinluo capsule than placebo (SBP: −9.40, −10.90 to −7.90, P < 0.00001; and DBP: −11.80, −12.40 to −11.20, P < 0.00001) or western medicine (SBP: −3.90, −4.93 to −2.87, P < 0.00001; and DBP: −3.70, −3.83 to −3.57, P < 0.00001). 12 trials reported adverse events without details. Conclusions. There is some but weak evidence about the effectiveness of TXL in treating patients with hypertension.
Highlights
With an ageing worldwide population coupled with unhealthy lifestyles and increased medical intervention, the burden of disease and overall mortality has shifted gradually to primarily noncommunicable diseases such as cardiovascular diseases
Literature searches were conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (October, 2013), The PubMed, EMBASE, Chinese Bio-Medical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database, and Wanfang Data
Full texts of articles [41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65] were retrieved, and articles were excluded with reasons listed as the following: participants did not meet the inclusive criteria (n = 20), duplication (n = 2), no control group (n = 1), and no data for extraction (n = 3)
Summary
With an ageing worldwide population coupled with unhealthy lifestyles and increased medical intervention, the burden of disease and overall mortality has shifted gradually to primarily noncommunicable diseases such as cardiovascular diseases. Hypertension is the most common risk factor for cardiovascular diseases (CVD) [1]. It has become a growing public health concern, in developing countries, with an estimated prevalence of 37.3%, in comparison with 22.9% in industrialized nations. It is well known that lowering blood pressure decreases the risk of cardiovascular diseases (CVDs) and cerebrovascular diseases in people with moderate to severe hypertension [7,8,9]. Approximately one-half of the patients with high blood pressure (BP) are not compliant with classifications of antihypertensive agents for various reasons including treatment cost, adverse effects, and complications [10,11,12,13]. There is some but weak evidence about the effectiveness of TXL in treating patients with hypertension
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