Randomised controlled trials (RCTs) of renin-angiotensin-aldosterone system inhibitors, angiotensin-converting enzyme inhibitors or AT1 (angiotensin II type 1) receptor blockers versus control in patients with hypertension were eligible for inclusion. Controls could include active control, usual care or placebo. The primary end-point was all-cause mortality. Trials in which patients were selected because of a specific disease (such as heart failure, acute coronary syndromes, acute stroke, haemodialysis, atrial fibrillation) or post-cardiac surgery were excluded. Trials with fewer than 100 patients or a low incidence (less than 10 events) of all-cause mortality were excluded.
The included trials studied various drugs including losartan, irbesartan, lisinopril, enalapril, candesartan, valsartan, eprosartan and telmisartan. Control groups also varied widely and included placebo, amlodipine, nifedipine, atenolol and diuretic. The proportion of patients with hypertension ranged from 68.7% to 100% (mean 91%). Baseline systolic blood pressure ranged from 135 to 182 mmHg (mean 153 mmHg). The mean age of patients ranged from 58.9 to 83.8 years. The proportion of male patients varied from 35.5% to 80.2%. Trials were published between 2001 and 2010.
Two reviewers undertook study selection.