Decoding the efficacy and safety profiles of anti-hypertensive agents by targeting RAAS: A systematic review and meta-analysis of clinical trials

Abstract

Introduction:This study reviews the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI), nonsteroidal mineralocorticoid receptor antagonists (NMRA), brain rennin-angiotensin system (RAS) therapy, and ribonucleic acid (RNA)-based therapy with evaluating systolic blood pressure and diastolic blood pressure control as well safety by counting adverse events.

Methods:Risk of Bias 2.0 were used for quality appraisal and RevMan 5.4 was applied for the meta-analysis.

Results: From five databases, 20 articles were selected for review. Six high-risk and fourteen low-risk studies. ARNI and RNA-based therapies improved BP regulation, while NMRA and brain RAS were less effective in managing high blood pressure. In terms of safety, NMRA and RNA-based therapies had fewer adverse events, whereas ARNI and brain RAS had more AEs compared to their control groups.

Conclusion: RNA-based therapy outperforms the four antihypertensive drugs studied in terms of efficacy and safety, underscoring its potential as the leading option and justifying further research.