Effect of combined drospirenone with estradiol for hypertensive postmenopausal women: a systemic review and meta-analysis

Abstract

Postmenopausal hypertensive is associated with estrogen deficiency. This meta-analysis was performed to assess the efficacy and safety of drospirenone combined with 17-β-estradiol (DRSP/E2) in postmenopausal hypertensive women. A systemic literature search of PubMed, Embase, Cochrane Library, Web of Science (up to Oct. 2015) was performed. Studies were screened independently by two researchers according to the inclusion and exclusion criteria which included only the randomized controlled trials (RCT) about the drospirenone with 17-β-estradiol for postmenopausal women with hypertension. The methodological quality was evaluated by Cochrane handbook 5.1.0 and meta-analysis was conducted using RevMan 5.3.0 software. Five randomized controlled trials involved 1121 patients who met the eligibility criteria. Overall, DRSP/E2 group was superior in reducing clinical blood pressure (BP) and 24-h mean BP. There was no significant change in potassium levels on DRSP/E2 group versus control group, suggesting probability potassium sparing effect of this hormone therapy. The incidences of adverse events were low and similar. The current evidences indicate that DRSP 3 mg/E2 2 mg can significantly lower both systolic and diastolic blood pressure in postmenopausal hypertensive women.

Chinese abstract

绝经后高血压与雌激素缺乏有关。这项荟萃分析用来评估屈螺酮联合17-β雌二醇(DRSP/E2) 治疗绝经后高血压妇女的有效性和安全性。在PubMed、EMbase、Cochrane Library、Web of Science上进行系统的文献检索(截止2015年10月) 。由两名研究人员根据纳入标准和排除标准研究独立筛选研究, 仅包括屈螺酮联合17-β雌二醇治疗绝经后高血压妇女的随机对照试验(RCT) 。方法学质量由Cochrane Handbook 5.1.0评估, 荟萃分析使用RevMan 5.3.0软件。5个随机对照试验, 共涉及1121例符合资格标准的患者。总的来说, DRSP/E2组在降低临床血压(BP) 和24h平均血压方面更有优势。DRSP/E2组和对照组之间钾水平没有明显的差异, 提示该激素治疗可能存在保钾作用。不良事件的发生率较低且相似。目前的证据表明: DRSP 3mg/E2 2mg能显著降低绝经后高血压妇女的收缩压和舒张压。

Keywords:

• Drospirenone
• estrogen
• hypertension
• meta-analysis
• postmenopausal

Declaration of interest

No interest conflicts were declared. This study was supported by the National Natural Science Foundation of China (NSFC-81270332), Gansu Province Natural Science Foundation (1104FKCA150, 1205TCYA042), and the Gansu Administration of Traditional Medicine Foundation (GZK-2010-Z-1).