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已发表论文
选择性 5-羟色胺再摄取抑制剂在抑郁症治疗中对血压影响的综合分析：安慰剂、5-羟色胺再摄取抑制剂和去甲肾上腺素再摄取抑制剂对照试验的结果
Authors Zhong Z, Wang L, Wen X, Liu Y, Fan Y, Liu Z
Received 15 May 2017
Accepted for publication 18 July 2017
Published 7 November 2017 Volume 2017:13 Pages 2781—2796
DOI https://doi.org/10.2147/NDT.S141832
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Prof. Dr. Roumen Kirov
Peer reviewer comments 2
Editor who approved publication: Professor Wai Kwong Tang
Background: Selective
serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake
inhibitors (SNRIs) have been commonly prescribed for depression treatment.
However, their effects on blood pressure are unclear.
Materials and methods: Effects on blood pressure of depressive patients in two groups (SSRIs versus placebo and SSRIs versus SNRIs) were evaluated. A search was conducted for double-blind, randomized controlled trials (RCTs) in PubMed, EMBASE, ISI Web of Science, PsycNET, CCRCT, and DARE (up to March 2017). The outcomes were systolic blood pressure (SBP) changes and diastolic blood pressure (DBP) changes from baseline to endpoint or to a certain period of treatment duration. Weighted mean differences (WMDs) and 95% CIs were calculated and pooled using random effects models. The χ 2 test and I 2 statistics were used to assess heterogeneity. Funnel plots, Begg’s test, and Egger’s test were used to estimate publication bias.
Results: A total of 23 RCTs involving 13,285 participants were included. Patients on SSRIs showed no significant differences in blood pressure changes compared with placebo. In the group of SSRIs versus SNRIs, overall SBP changes and DBP changes revealed statistical significances (WMD 1.5 mmHg, 95% CI -2.15, -0.84, Z =4.46, P <0.00001 and WMD 1.34 mmHg, 95% CI -1.92, -0.75, Z =6.18, P <0.00001). Subgroup analyses on treatment duration and age further evidenced these findings.
Conclusion: It was established that SSRIs did not affect blood pressure, while SNRIs led to a modest increase in SBP and DBP with statistical significance compared with SSRIs.
Keywords: meta-analysis, blood pressure change, depression treatment, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors, depression, antidepressant, systolic blood pressure, diastolic blood pressure
Materials and methods: Effects on blood pressure of depressive patients in two groups (SSRIs versus placebo and SSRIs versus SNRIs) were evaluated. A search was conducted for double-blind, randomized controlled trials (RCTs) in PubMed, EMBASE, ISI Web of Science, PsycNET, CCRCT, and DARE (up to March 2017). The outcomes were systolic blood pressure (SBP) changes and diastolic blood pressure (DBP) changes from baseline to endpoint or to a certain period of treatment duration. Weighted mean differences (WMDs) and 95% CIs were calculated and pooled using random effects models. The χ 2 test and I 2 statistics were used to assess heterogeneity. Funnel plots, Begg’s test, and Egger’s test were used to estimate publication bias.
Results: A total of 23 RCTs involving 13,285 participants were included. Patients on SSRIs showed no significant differences in blood pressure changes compared with placebo. In the group of SSRIs versus SNRIs, overall SBP changes and DBP changes revealed statistical significances (WMD 1.5 mmHg, 95% CI -2.15, -0.84, Z =4.46, P <0.00001 and WMD 1.34 mmHg, 95% CI -1.92, -0.75, Z =6.18, P <0.00001). Subgroup analyses on treatment duration and age further evidenced these findings.
Conclusion: It was established that SSRIs did not affect blood pressure, while SNRIs led to a modest increase in SBP and DBP with statistical significance compared with SSRIs.
Keywords: meta-analysis, blood pressure change, depression treatment, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors, depression, antidepressant, systolic blood pressure, diastolic blood pressure
