The randomized single-blind study was designed to compare the effects of captopril Cap),and nadolol(And)on renal hemodynamics in 60 patients with essential hyperttnsion.They were divided into two groups at random.Cap ...The randomized single-blind study was designed to compare the effects of captopril Cap),and nadolol(And)on renal hemodynamics in 60 patients with essential hyperttnsion.They were divided into two groups at random.Cap was given in dosage of 37.5-75 mg/d per os and And 40-80 mg/d.The results show that both drugs increase the blood volume distributed to the kidneys from cardiac output(renal blood flow/cardiac output),Cap increasing 10% (P<0. 05) and And 8%(F<0.05) Renal vascular resistance(RVR)is lowered by the two drugs,13%(P<0. 05) by Cap and 11%(P<0.05) by And.These suggest that both drugs facilitate the maintenance of renal blood circulation in patients with essential hypeitension.being beneficial for long-term treatment of hypertension.展开更多
Currently, nonselective β-blockers(NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by b...Currently, nonselective β-blockers(NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis(PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during followup is compared between the two groups. Additionally,subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.展开更多
Background and Aims:We aimed to perform a network meta-analysis(NWM)to examine comparative effectiveness of non-selective beta blockers(NSBBs)on prophylaxis of gastroesophageal variceal bleeding(GVB)and mortality bene...Background and Aims:We aimed to perform a network meta-analysis(NWM)to examine comparative effectiveness of non-selective beta blockers(NSBBs)on prophylaxis of gastroesophageal variceal bleeding(GVB)and mortality benefit.Methods:MEDLINE(OVID)and EMBASE databases were searched for eligible randomized clinical trials(RCTs)from inception to July 3,2021.Outcomes of interest included primary/secondary prophylaxis of GVB,failure to achieve hepatic venous pressure gradient(HVPG)decremental response,liver-related and all-cause mortality.A Bayesian NWM was performed to derive relative risk(RR)with 95%credible intervals(CrIs).The ranking probability of each NSBB was assessed by surface under cumulative ranking curve(SUCRA).Results:Thirty-three RCTs including 3,188 cirrhosis patients with gastroesophageal varices were included.Compared with placebo,nadolol ranked first for reducing variceal bleeding[RR:0.25,(95%CrI:0.11–0.51);SUCRA:0.898],followed by carvedilol[RR:0.33,(95%CrI:0.11–0.88);SUCRA:0.692]and propranolol[RR:0.52,(95%CrI:0.37–0.75);SUCRA:0.405].Carvedilol was more effective than propranolol in achieving HVPG decremental response[RR:0.43,(95%CrI:0.26–0.69)].Carvedilol ranked first for reducing all-cause mortality[RR:0.32,(95%CrI:0.17–0.57);SUCRA:0.963],followed by nadolol[RR:0.48,(95%CI:0.29–0.77);SUCRA:0.688],and propranolol[RR:0.77,(95%CI:0.58–1.02);SUCRA:0.337].Similar findings were observed for liver-related mortality.Carvedilol ranked the safest.The RR of adverse events was 4.38,(95%CrI:0.33–161.4);SUCRA:0.530,followed by propranolol[RR:7.54,(95%CrI:1.90–47.89);SUCRA:0.360],and nadolol[RR:18.24,(95%CrI:91.51–390.90);SUCRA:0.158].Conclusions:Carvedilol is the preferred NSBB with better survival benefit and lower occurrence of adverse events among patients with gastroesophageal varices.展开更多
文摘The randomized single-blind study was designed to compare the effects of captopril Cap),and nadolol(And)on renal hemodynamics in 60 patients with essential hyperttnsion.They were divided into two groups at random.Cap was given in dosage of 37.5-75 mg/d per os and And 40-80 mg/d.The results show that both drugs increase the blood volume distributed to the kidneys from cardiac output(renal blood flow/cardiac output),Cap increasing 10% (P<0. 05) and And 8%(F<0.05) Renal vascular resistance(RVR)is lowered by the two drugs,13%(P<0. 05) by Cap and 11%(P<0.05) by And.These suggest that both drugs facilitate the maintenance of renal blood circulation in patients with essential hypeitension.being beneficial for long-term treatment of hypertension.
文摘Currently, nonselective β-blockers(NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis(PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during followup is compared between the two groups. Additionally,subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.
文摘Background and Aims:We aimed to perform a network meta-analysis(NWM)to examine comparative effectiveness of non-selective beta blockers(NSBBs)on prophylaxis of gastroesophageal variceal bleeding(GVB)and mortality benefit.Methods:MEDLINE(OVID)and EMBASE databases were searched for eligible randomized clinical trials(RCTs)from inception to July 3,2021.Outcomes of interest included primary/secondary prophylaxis of GVB,failure to achieve hepatic venous pressure gradient(HVPG)decremental response,liver-related and all-cause mortality.A Bayesian NWM was performed to derive relative risk(RR)with 95%credible intervals(CrIs).The ranking probability of each NSBB was assessed by surface under cumulative ranking curve(SUCRA).Results:Thirty-three RCTs including 3,188 cirrhosis patients with gastroesophageal varices were included.Compared with placebo,nadolol ranked first for reducing variceal bleeding[RR:0.25,(95%CrI:0.11–0.51);SUCRA:0.898],followed by carvedilol[RR:0.33,(95%CrI:0.11–0.88);SUCRA:0.692]and propranolol[RR:0.52,(95%CrI:0.37–0.75);SUCRA:0.405].Carvedilol was more effective than propranolol in achieving HVPG decremental response[RR:0.43,(95%CrI:0.26–0.69)].Carvedilol ranked first for reducing all-cause mortality[RR:0.32,(95%CrI:0.17–0.57);SUCRA:0.963],followed by nadolol[RR:0.48,(95%CI:0.29–0.77);SUCRA:0.688],and propranolol[RR:0.77,(95%CI:0.58–1.02);SUCRA:0.337].Similar findings were observed for liver-related mortality.Carvedilol ranked the safest.The RR of adverse events was 4.38,(95%CrI:0.33–161.4);SUCRA:0.530,followed by propranolol[RR:7.54,(95%CrI:1.90–47.89);SUCRA:0.360],and nadolol[RR:18.24,(95%CrI:91.51–390.90);SUCRA:0.158].Conclusions:Carvedilol is the preferred NSBB with better survival benefit and lower occurrence of adverse events among patients with gastroesophageal varices.
