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Meta-Analysis
. 2016 Dec 21;12(12):CD007655.
doi: 10.1002/14651858.CD007655.pub3.

Blood pressure-lowering efficacy of reserpine for primary hypertension

Sandy D Shamon  1 , Marco I Perez  2
Affiliations
Meta-Analysis

Blood pressure-lowering efficacy of reserpine for primary hypertension

Sandy D Shamon et al. Cochrane Database Syst Rev. .

Abstract

Background: Many antihypertensive agents exist today for the treatment of primary hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, or both). Randomised controlled trials (RCTs) have been carried out to investigate the evidence for these agents. There is, for example, strong RCT evidence that thiazides reduce mortality and morbidity. Some of those trials used reserpine as a second-line therapy. However, the dose-related blood pressure reduction with this agent is not known.

Objectives: The primary objective of this review was to quantify the dose-related efficacy of reserpine versus placebo or no treatment in reducing systolic blood pressure (SBP) or diastolic blood pressure (DBP), or both.We also aimed to evaluate the dose-related effects of reserpine on mean arterial blood pressure (MAP) and heart rate (HR), as well as the dose-related effects on withdrawals due to adverse events.

Search methods: We searched the Cochrane Hypertension Group Specialised Register (January 1946 to October 2016), CENTRAL (2016, Issue 10), MEDLINE (January 1946 to October 2016), Embase (January 1974 to October 2016), and ClinicalTrials.gov (all dates to October 2016). We also traced citations in the reference sections of the retrieved studies.

Selection criteria: Included studies were truly randomised controlled trials (RCTs) comparing reserpine monotherapy to placebo or no treatment in participants with primary hypertension.

Data collection and analysis: We assessed methods of randomisation and concealment. We extracted and analysed data on blood pressure reduction, heart rate, and withdrawal due to adverse effects.

Main results: We found four RCTs (with a total of 237 participants) that met the inclusion criteria, none of which we found through the 2016 update search. The overall pooled effect demonstrates a statistically significant systolic blood pressure (SBP) reduction in participants taking reserpine compared with placebo (weighted mean difference (WMD) -7.92, 95% confidence interval (CI) -14.05 to -1.78). Because of significant heterogeneity across the trials, a significant effect in diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) could not be found. A dose of reserpine 0.5 mg/day or greater achieved the SBP effects. However, we could not determine the dose-response pattern because of the small number of trials. We did not combine data from the trial that investigated Rauwiloid against placebo with reserpine data from the remaining three trials. This is because Rauwiloid is a different alkaloid extract of the plant Rauwolfia serpentina, and the dose used is not comparable to reserpine. None of the included trials reported withdrawals due to adverse effects.

Authors' conclusions: Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs. However, we could not make definite conclusions regarding the dose-response pattern because of the small number of included trials. More RCTs are needed to assess the effects of reserpine on blood pressure and to determine the dose-related safety profile before the role of this drug in the treatment of primary hypertension can be established.

PubMed Disclaimer

Conflict of interest statement

Sandy Shamon: nothing to declare. Marco Perez: nothing to declare.

Figures

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1
QUOROM flowchart of search results
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2
Search results (updated review 2016)
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Forest plot of comparison: 1 Reserpine versus placebo, outcome: 1.1 Weighted mean change in systolic blood pressure.
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Forest plot of comparison: 1 Reserpine versus placebo, outcome: 1.2 Weighted mean change in diastolic blood pressure.
1.1
1.1. Analysis
Comparison 1 Reserpine versus placebo, Outcome 1 Weighted mean change in systolic blood pressure.
1.2
1.2. Analysis
Comparison 1 Reserpine versus placebo, Outcome 2 Weighted mean change in diastolic blood pressure.
1.3
1.3. Analysis
Comparison 1 Reserpine versus placebo, Outcome 3 Weighted mean change in mean arterial pressure.
1.4
1.4. Analysis
Comparison 1 Reserpine versus placebo, Outcome 4 Weighted mean change in heart rate.
2.1
2.1. Analysis
Comparison 2 Rauwolfia versus placebo, Outcome 1 Weighted mean change in systolic blood pressure.
2.2
2.2. Analysis
Comparison 2 Rauwolfia versus placebo, Outcome 2 Weighted mean change in diastolic blood pressure.
2.3
2.3. Analysis
Comparison 2 Rauwolfia versus placebo, Outcome 3 Weighted mean change in heart rate.
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References

References to studies included in this review

Kfogsgaard 1957 {published data only}
    1. Kfogsgaard AR. Hypotensive effect of reserpine compared with phenobarbital and placebo. Acta Medica Scandinavica 1957;157(5):379‐85. - PubMed
Shapiro 1957 {published data only}
    1. Shapiro AP, Teng HC. Technic of controlled drug assay illustrated by a comparative study of Rauwolfia serpentina, phenobarbital and placebo in the hypertensive patient. The New England Journal of Medicine 1957;256(21):970‐5. - PubMed
VACS 1960 {published data only}
    1. Veterans Administration Cooperative Group (VACS). A double blind control study of antihypertensive agents. I. Comparative effectiveness of reserpine, reserpine and hydralazine, and three ganglionic blocking agents, chlorisondamine, mecamyamine, and pentolinium tartrate. Archives of Internal Medicine 1960;106:81‐96. - PubMed
Velasco 1975 {published data only}
    1. Velasco M, Arbona J, Guevara J, Torres J. A randomized double‐blind study of furosemide‐reserpine in essential hypertension. Current Therapeutic Research, Clinical and Experimental 1975;18(3):395‐9. - PubMed

References to studies excluded from this review

Achor 1955 {published data only}
    1. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina and with reserpine; controlled study disclosing occasional severe depression. Journal of the American Medical Association 1955;159(9):841‐5. - PubMed
Bello 1956 {published data only}
    1. Bello CT, Turner LW. Reserpine as an antihypertensive in the outpatient clinic, a double blind clinical study. The American Journal of the Medical Sciences 1956;232(2):194‐7. - PubMed
Christman 1956 {published data only}
    1. Christman RS. Efficacy of Rauwolfia serpentina preparations in the treatment of hypertension in general medical practice: a clinical comparison of three regimens. American Practitioner and Digest of Treatment 1956;7(4):614‐7. - PubMed
Johnson 1961 {published data only}
    1. Johnson RW, Sosa G, Morita Y, Mader IJ. Anti‐hypertensive effects of chlorothiazide, reserpne and placebo. A double‐blind evaluation. Michigan State Medical Society 1961;60:1420‐3. - PubMed
Lee 1956 {published data only}
    1. Lee R, Seligmann AM, Goebel D, Fulton LA, Clark MA. Reserpine‐hydralazine combination therapy of hypertensive disease, with hydralazine in doses generally below the toxic range. Annals of Internal Medicine 1956;44(3):456‐65. - PubMed
Palmer 1955 {published data only}
    1. Palmer RS. The hypotensive action of Rauwolfia serpentina and reserpine: a double hidden placebo study of ambulatory patients with hypertension. American Practitioner and Digest of Treatment 1955;6(9):1323‐7. - PubMed
Sheldon 1957 {published data only}
    1. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long‐term double‐blind study.. Circulation 1957;16(2):200‐6. - PubMed
Sosa 1960 {published data only}
    1. Sosa G, Morita Y, Mader IJ. A double blind evaluation of the antihypertensive effect of reserpine, phenobarbital, hydralazine, syrosingopine, and placebo in ambulatory subjects. Angiology 1960;11(5):381‐6.
Suckle 1956 {published data only}
    1. Suckle E. Comparison of Rauwolfia drugs in treatment of hypertension. Geriatrics 1956;11(11):509‐13. - PubMed

Additional references

Agnew 1963
    1. Agnew TM, Irvine ROH, North JDK. Methyldopa and hydrochlorothiazide compared with reserpine and hydrochlorothiazide in hypertension. British Medical Journal 1963;2(5360):781‐3. - PMC - PubMed
ALLHAT 2002
    1. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high‐risk hypertensive patients randomized to angiotensin‐converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002;288(23):2981‐97. - PubMed
Blackman 1959
    1. Blackman JG, Campion DS, Fastier FN. Mechanism of action of reserpine in producing gastric haemorrhage and erosion in the mouse. British Journal of Pharmacology and Chemotherapy 1959;14(1):112‐6. - PMC - PubMed
Bracharz 1971
    1. Bracharz H, Laas H. Clinical‐pharmacologic studies and therapy with anti‐hypertensive furosemide‐reserpine preparations. Medizinische Klinik 1971;66(23):1113‐7. - PubMed
Chakravarty 1951
    1. Chakravarty NK, Rai Chaudhuri MN. Rauwolfia serpentina in essential hypertension. Indian Medical Gazette 1951;86(8):348‐54. - PMC - PubMed
Chekman 1972
    1. Chekman IS. Experimental investigation of the mechanism of action of reserpine. Bulletin of Experimental Biology and Medicine 1972;73(3):291‐3. - PubMed
De Divitiis 1981
    1. Divitiis O, Petitto M, Somma S. Atenolol, chlorthalidone, and reserpine in mild‐moderate hypertension: double‐blind comparison. Drugs Under Experimental & Clinical Research 1981;7(6):773‐9.
Doyle 1954
    1. Doyle AE, Smirk FH. Hypotensive action of reserpine. Lancet 1954;266(6822):1096‐7. - PubMed
Ferguson 1975
    1. Ferguson RK, Rothenberg RJ. Comparative efficacy of reserpine and guanethidine in thiazide‐treated patients with mild to moderate essential hypertension. Clinical Pharmacology & Therapeutics 1975;17(2):233.
Ferguson 1976
    1. Ferguson RK, Rothenberg RJ, Nies AS. Patient acceptance of guanethidine as therapy for mild to moderate hypertension. A comparison with reserpine. Circulation 1976;54(1):32‐7. - PubMed
Finnerty 1954
    1. Finnerty FA. The value of rauwolfia serpentine in the hypertensive patient. American Journal of Medicine 1954;17(5):629‐40. - PubMed
Finnerty 1979
    1. Finnerty FA Jr, Gyftopoulos A, Berry C, McKenney A. Step 2 regimens in hypertension. An assessment. JAMA 1979;241(6):579‐81. - PubMed
Finnerty 1980
    1. Finnerty FA Jr. Chlorthalidone plus reserpine versus hydrochlorothiazide plus reserpine in a stepped‐care approach to the treatment of essential hypertension. Journal of Clinical Pharmacology 1980;20(5‐6 Pt 1):357‐63. - PubMed
Gaskin 1972
    1. Gaskin R. The clinical effectiveness of dihydroergocristine ‐ reserpine clopamide combination in the treatment of hypertension. Standing Advisory Committee for Medical Research in the British Caribbean Bahamas 1972;17th Scientific Meeting:56p.
Glazer 1972
    1. Glazer N. Reserpine, hydralazine, hydrochlorothiazide combination(Ser‐AP‐ES) in essential hypertension. Current Therapeutic Research, Clinical and Experimental 1972;14(9):561‐72. - PubMed
Griebenow 1997
    1. Griebenow R, Pittrow DB, Weidinger G, Mueller E, Mutschler E, Welzel D. Low‐dose reserpine/thiazide combination in first‐line treatment of hypertension: efficacy and safety compared to an ACE inhibitor. Blood Pressure 1997;6(5):299‐306. - PubMed
Heran 2008a
    1. Heran BS, Wong MM, Heran IK, James MW. Blood pressure lowering efficacy of angiotensin converting enzyme (ACE) inhibitors for primary hypertension. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD003823.pub2] - DOI - PMC - PubMed
Heran 2008b
    1. Heran BS, Wong MM, Heran IK, Wright JM. Blood pressure lowering efficacy of angiotensin receptor blockers for primary hypertension. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD003822.pub2] - DOI - PMC - PubMed
Hughes 1955
    1. Hughes WH, Dennis E, Moyer JH. Treatment of hypertension with oral reserpine alone and in combination with hydralazine and hexamethonium. The American Journal of the Medical Sciences 1955;229(2):121‐34. - PubMed
INAGAKI 1978
    1. INAGAKI Yoshiaki, et al. Therapeutic efficacy of oxprenolol in essential hypertension: a double‐blind comparison with reserpine. Japanese Pharmacology and Therapeutics 1978;6(4):1097‐108.
Josebury 1976
    1. Joesbury HE, Phillips CA, Garrett RT, Wilkes E, Smith AJ. Mild hypertension: a clinical trial conducted in hospital general practice. British Medical Journal 1976;2(6050):1476‐9. - PMC - PubMed
Jüni 2001
    1. Jüni P, Altman DG, Egger M. Systematic reviews in health care: assessing the quality of controlled clinical trials. BMJ 2001;323(7303):42‐6. - PMC - PubMed
Kanda 1977
    1. Kanda Y, et al. Clinical efficacy of apllobal for essential hypertension: a multicenter double‐blind controlled comparison with reserpine. The Japanese Journal of Clinical and Experimental Medicine 1977;54(11):3796‐804.
Kennedy 1971
    1. Kennedy CC, Spiekerman RE, Elveback L. Antihypertensive properties of cryptenamine used with reserpine and methyclothiazide. Journal of Pharmaceutical Sciences 1971;60(8):1139‐41. - PubMed
Krogsgaard 1958
    1. Krogsgaard AR. The role of reserpine in essential hypertension when used alone or combined with hydralazine. Acta Medica Scandinavica 1958;162(6):449‐63. - PubMed
Krämer 1977
    1. Krämer KD, Ghabussi P, Hochrein H. Antihypertensive combination‐therapy with inositol nicotinate in essential hypertension. Die Medizinische Welt 1977;28(27):1198‐201. - PubMed
Krönig 1997
    1. Krönig B, Pittrow DB, Kirch W, Welzel D, Weidinger G. Different concepts in first‐line treatment of essential hypertension. Comparison of a low‐dose reserpine‐thiazide combination with nitrendipine monotherapy. German Reserpine in Hypertension Study Group. Hypertension 1997;29(2):651‐8. - PubMed
Kuhns 1954
    1. Kuhns K, Djuranovic R, Gehrs C, Koppen K. Comparative clinical studies on the effect of hydrazine phthalazine and the rauwolfia alkaloid reserpine on blood pressure. Klinische Wochenschrift 1954;32(37‐8):930‐5. - PubMed
Labarthe 1979
    1. Labarthe DR. Methodological variation in case‐control studies of reserpine and breast cancer. Journal of Chronic Diseases 1979;32(1‐2):95‐104. - PubMed
Law 2003
    1. Law MR, Wald NJ, Morris JK, Jordan RE. Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. BMJ 2003;326(7404):1427. - PMC - PubMed
Leary 1989
    1. Leary WP, Ryes AJ, Van DBK, Maharaj B. Antihypertensive effects of clopamide administered alone in combination with pindolol or with reserpine and dihydroergocristine. Current therapeutic Research, Clinical and Experimental 1989;46(6):1224‐35.
Liebowitz 1957
    1. Liebowitz D, Carbone JV. Effect of varying doses of reserpine on gastric secretion. The New England Journal of Medicine 1957;257(5):227‐8. - PubMed
Manyemba 1997
    1. Manyemba J. A randomised crossover comparison of reserpine and sustained‐release nifedipine in hypertension. The Central African Journal of Medicine 1997;43(12):344‐9. - PubMed
Mattes 1977
    1. Mattes JA, Martin D. Propranolol in the treatment of essential hypertension. Journal of the American Medical Association 1977;237(21):2303‐10. - PubMed
Nicaise 1973
    1. Nicaise J, Ghirardi P. Double‐blind cross‐over study of the hypotensive action of reserpine alone and associated with a diuretic (mebutizide). Bruxelles Medical 1973;53(11):683‐8. - PubMed
Ogawa 1984
    1. Ogawa K, Ban M, Ito T, Watanabe T, Kobayashi T, Yamazaki N, et al. Diltiazem for treatment of essential hypertension: a double‐blind controlled study with reserpine. Clinical Therapeutics 1984;6(6):844‐53. - PubMed
Parkes 1969
    1. Parkes WE, Agarwal AP, Hunt LB. Treatment of hypertension with quinethazone alone or in combination with reserpine. The Practitioner 1969;203(214):194‐8. - PubMed
RevMan 2014 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rösler 1975
    1. Rösler F, Wegener H, Eulenberger D, Dahme B. The effect of an antihypertensive drug during psychological stress. A double‐blind study. Arzneimittel‐Forschung 1975;25(6):965‐72. - PubMed
Safar 1975
    1. Safar ME, Weiss YA, Corvol PL, Menard JE, London GM, Milliez PL. Anti‐hypertensive adrenergic‐blocking agents: effects on sodium balance, the renin‐angiotensin system and haemodynamics. Clinical Science and Molecular Medicine 1975;2:93s‐95s. - PubMed
Salmela 1981
    1. Salmela PI, Jounela AJ, Karppanen H. Double‐blind comparison of dihydralazine and prazosin in hypertensive patients on the diuretic‐reserpine regimen. Annals of Clinical Research 1981;13(6):433‐8. - PubMed
Schmidt 1991
    1. Schmidt A, Vetter W, Dennler HJ, Groll S, Orengo P. Combined uni‐ and multicenter double‐blind studies in hypertensive patients. Comparison of blood pressure measurements. Schweizerische Rundschau fur Medizin Praxis 1991;80(34):849‐55. - PubMed
Seedat 1984
    1. Seedat YK, Hoosen S, Bhigjee AI. Reserpine plus hydrochlorothiazide and sotalol plus hydrochlorothiazide in Black and Indian hypertensive patients. South African Medical Journal 1984;65(23):915‐7. - PubMed
SHEP 1989
    1. Probstfield JL, Applegate WB, Borhani NO, Curb JD, Cutler JA, Davis BR, et al. The Systolic Hypertension in the Elderly Program (SHEP): an intervention trial on isolated systolic hypertension. SHEP Cooperative Research Group. Clinical and Experimental Hypertension. Part A, Theory and Practice 1989;11(5‐6):973‐89. - PubMed
SHEP 1991
    1. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991;265(24):3255‐64. - PubMed
SHEP 1995
    1. Kostis JB, Berge KG, Davis BR, Hawkins CM, Probstfield J. Effect of atenolol and reserpine on selected events in the systolic hypertension in the elderly program (SHEP). American Journal of Hypertension 1995;8(12 Pt 1):1147‐53. - PubMed
SHEP 1996
    1. Curb JD, Pressel SL, Cutler JA, Savage PJ, Applegate WB, Black H, et al. Effect of diuretic‐based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA 1996;276(23):1886‐92. - PubMed
SHEP 1998a
    1. Davis BR, Vogt T, Frost PH, Burlando A, Cohen J, Wilson A, et al. Risk factors for stroke and type of stroke in persons with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. Stroke 1998;29(7):1333‐40. - PubMed
SHEP 1998b
    1. Pahor M, Shorr RI, Somes GW, Cushman WC, Ferrucci L, Bailey JE, et al. Diuretic‐based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the systolic hypertension in the elderly program. Archives of Internal Medicine 1998;158(12):1340‐5. - PubMed
SHEP 1998c
    1. Savage PJ, Pressel SL, Curb JD, Schron EB, Applegate WB, Black HR, et al. Influence of long‐term, low‐dose, diuretic‐based, antihypertensive therapy on glucose, lipid, uric acid, and potassium levels in older men and women with isolated systolic hypertension: The Systolic Hypertension in the Elderly Program. Archives of Internal Medicine 1998;158(7):741‐51. - PubMed
SHEP 2008
    1. Patel AB, Kostis JB, Wilson AC, Shea ML, Pressel SL, Davis BR. Long‐term fatal outcomes in subjects with stroke or transient ischemic attack: fourteen‐year follow‐up of the systolic hypertension in the elderly program. Stroke 2008;39(4):1084‐9. - PubMed
Smith 1969
    1. Smith WM, Thurm RH, Bromer L. Comparative evaluation of Rauwolfia whole root and reserpine. Clinical Pharmacology and Therapeutics 1969;10(3):338‐43. - PubMed
Smith 1977
    1. Smith WM. Treatment of mild hypertension: results of a ten‐year intervention trial. Circulation Research 1977;40(5 Suppl 1):I98‐205. - PubMed
Stein 1990
    1. Stein CM, Neill P, Mwaluko GM, Kusema T. Combination of a thiazide, a vasodilator and reserpine compared with methyldopa plus hydrochlorothiazide in the treatment of hypertension in Zimbabwe. South African Medical Journal 1990;77(5):243‐5. - PubMed
Stuppy 1955
    1. Stuppy LJ, Tober JN. Treatment of hypertension with reserpine (serpasil) alone and in combination with hydralazine (apresoline). Angiology 1955;6(3):253‐9. - PubMed
Torsti 1969
    1. Torsti P, Neuvonen PJ, Vapaatalo HI, Idänpään‐Heikkilä JE. Circulatory and diuretic effects of hydrochlorothiazide and reserpine in man. Annals of Clinical Research 1969;1(2):126‐30. - PubMed
VA‐NHLBI 1978
    1. Veterans Administration‐National Heart, Lung, and Blood Institute (VA‐NHLBI) Study Group for Evaluating Treatment in Mild Hypertension. Evaluation of drug treatment in mild hypertension: VA‐NHLBI feasibility trial. Plan and preliminary results of a two‐year feasibility trial for a multicenter intervention study to evaluate the benefits versus the disadvantages of treating mild hypertension. Prepared for the Veterans Administration‐National Heart, Lung, and Blood Institute Study Group for Evaluating Treatment in Mild Hypertension. Annals of the New York Academy of Sciences 1978;304:267‐92. - PubMed
VACS 1982
    1. Veterans Administration Cooperative Study (VACS) Participants. Low doses v standard dose of reserpine. A randomized, double‐blind, multiclinic trial in patients taking chlorthalidone. JAMA 1982;248(19):2471‐7. - PubMed
VACS 1990
    1. Materson BJ, Cushman WC, Goldstein G, Reda DJ, Freis ED, Ramirez EA, et al. Treatment of hypertension in the elderly: I. Blood pressure and clinical changes. Results of a Department of Veterans Affairs Cooperative Study. Hypertension 1990;15(4):348‐60. - PubMed
Van Hoose 1976
    1. Hoose MC, Cutler RE. Antihypertensive efficacy of metolazone (Zaroxolyn) alone and combined with reserpine in treatment of essential hypertension. Current Therapeutic Research, Clinical and Experimental 1976;20(3):266‐76. - PubMed
Wilkins 1953
    1. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. The New England Journal of Medicine 1953;248(2):48‐53. - PubMed
Wolff 1966
    1. Wolff FW, Lindeman RD. Effects of treatment in hypertension. Results of a controlled study. Journal of Chronic Diseases 1966;19(3):227‐40. - PubMed
Wright 1999
    1. Wright JM, Lee CH, Chambers GK. Systematic review of antihypertensive therapies: does the evidence assist in choosing a first‐line drug?. CMAJ 1999;161(1):25‐32. - PMC - PubMed
Wright 2008
    1. Wright JT Jr, Harris‐Haywood S, Pressel S, Barzilay J, Baimbridge C, Bareis CJ, et al. Clinical outcomes by race in hypertensive patients with and without the metabolic syndrome: Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Archives of Internal Medicine 2008;168(2):207‐17. - PMC - PubMed
Wright 2009
    1. Wright JM, Musini VM. First‐line drugs for hypertension. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD001841.pub2] - DOI - PubMed

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