{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:52:31Z","timestamp":1791561151546,"version":"4.3.4"},"reference-count":113,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis to compare benefits and harms of different antihypertensive drug classes in kidney transplant recipients, as post-transplant hypertension (HTN) associates with increased cardiovascular (CV) morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing all main antihypertensive agents versus placebo\/no treatment, routine treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The search identified 71 RCTs. Calcium channel blockers (CCBs) (26 trials) reduced the risk for graft loss {risk ratio [RR] 0.58 [95% confidence interval (CI) 0.38\u20130.89]}, increased glomerular filtration rate (GFR) [mean difference (MD) 3.08\u2009mL\/min (95% CI 0.38\u20135.78)] and reduced blood pressure (BP). Angiotensin-converting enzyme inhibitors (ACEIs) (13 trials) reduced the risk for graft loss [RR 0.62 (95% CI 0.40\u20130.96)] but decreased renal function and increased the risk for hyperkalaemia. Angiotensin receptor blockers (ARBs) (10 trials) did not modify the risk of death, graft loss and non-fatal CV events and increased the risk for hyperkalaemia. When pooling ACEI and ARB data, the risk for graft failure was lower in renin\u2013angiotensin system (RAS) blockade as compared with control treatments. In direct comparison with ACEIs or ARBs (11 trials), CCBs increased GFR [MD 11.07\u2009mL\/min (95% CI 6.04\u201316.09)] and reduced potassium levels but were not more effective in reducing BP. There are few available data on mortality, graft loss and rejection. Very few studies performed comparisons with other active drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CCBs could be the preferred first-step antihypertensive agents in kidney transplant patients, as they improve graft function and reduce graft loss. No definite patient or graft survival benefits were associated with RAS inhibitor use over conventional treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfz092","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T07:08:57Z","timestamp":1555312137000},"page":"878-887","source":"Crossref","is-referenced-by-count":52,"title":["Comparative effectiveness of different antihypertensive agents in kidney transplantation: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"35","author":[{"given":"Anna","family":"Pisano","sequence":"first","affiliation":[{"name":"CNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Bolignano","sequence":"additional","affiliation":[{"name":"CNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mallamaci","sequence":"additional","affiliation":[{"name":"CNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziella","family":"D\u2019Arrigo","sequence":"additional","affiliation":[{"name":"CNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Halimi","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie et Immunologie clinique, CHRU de Tours\u2014H\u00f4pital Bretonneau, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Persu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cliniques Universitaires Saint-Luc, Universit\u00e9 catholique de Louvain, Brussels, Belgium"},{"name":"Pole of Cardiovascular Research, Institut de Recherche Exp\u00e9rimentale et Clinique, Universit\u00e9 catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregoire","family":"Wuerzner","sequence":"additional","affiliation":[{"name":"Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Sarafidis","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Aristotle University of Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Watschinger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Nephrology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Burnier","sequence":"additional","affiliation":[{"name":"Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Zoccali","sequence":"additional","affiliation":[{"name":"CNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"2021020408352146000_gfz092-B1","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1053\/ajkd.2001.28924","article-title":"Cardiovascular disease and the renal transplant recipient","volume":"38","author":"Kendrick","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"2021020408352146000_gfz092-B2","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1093\/ndt\/gfl095","article-title":"Renal transplant dysfunction\u2014importance quantified in comparison with traditional risk factors for cardiovascular disease and mortality","volume":"21","author":"Soveri","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"2021020408352146000_gfz092-B3","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1681\/ASN.2013040435","article-title":"BP, cardiovascular disease, and death in the folic acid for vascular outcome 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