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Meta-Analysis
. 2013 Jun;15(6):435-42.
doi: 10.1111/j.1751-7176.2012.00701.x. Epub 2012 Aug 20.

Effect of allopurinol on blood pressure: a systematic review and meta-analysis

Vikram Agarwal  1 , Nidhi Hans, Franz H Messerli
Affiliations
Meta-Analysis

Effect of allopurinol on blood pressure: a systematic review and meta-analysis

Vikram Agarwal et al. J Clin Hypertens (Greenwich). 2013 Jun.

Abstract

Allopurinol is a potent xanthine oxidase inhibitor that is used in hyperuricemic patients to prevent gout. It has also been shown to decrease cardiovascular complications in a myriad of cardiovascular conditions. However, studies have reported conflicting evidence on its effects on blood pressure (BP). A systematic review was conducted using Medline, PubMed, Embase, and the Cochrane Library for all the longitudinal studies that assessed the efficacy of allopurinol on systolic and diastolic BP. A total of 10 clinical studies with 738 participants were included in the analysis. Compared with the control group, systolic BP decreased by 3.3 mm Hg (95% confidence interval [CI], 1.4-5.3 mm Hg; P=.001) and diastolic BP decreased by 1.3 mm Hg (95% CI, 0.1-2.5 mm Hg; P=.03) in patients treated with allopurinol. When analysis was restricted to the higher-quality randomized controlled trials, similar changes in systolic and diastolic BPs were found: 3.3 mm Hg (95% CI, 0.8-5.8 mm Hg; P<.001) and 1.4 mm Hg (95% CI, 0.1-2.7 mm Hg; P=.04), respectively. Allopurinol is associated with a small but significant reduction in BP. This effect can be potentially exploited to aid in controlling BP in hypertensive patients with hyperuricemia.

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Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram of study selection.
Figure 2
Figure 2
Forest plot showing the effect of allopurinol on systolic blood pressure. WMD indicates weighted mean difference; CI, confidence interval.
Figure 3
Figure 3
Forest plot showing the effect of allopurinol on diastolic blood pressure. WMD indicates weighted mean difference; CI, confidence interval.
Figure 4
Figure 4
Metaninf analysis for changes in systolic blood pressure with allopurinol use. CI indicates confidence interval.
Figure 5
Figure 5
Metaninf analysis for changes in diastolic blood pressure with allopurinol use. CI indicates confidence interval.
Figure 6
Figure 6
Subgroup analysis for changes in systolic blood pressure with allopurinol use.
Figure 7
Figure 7
Subgroup analysis for changes in diastolic blood pressure with allopurinol use.
See this image and copyright information in PMC

Comment in

References

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