Comparative effectiveness and safety of novel antihypertensive agents (anri inhibitors) versus standard therapies: a meta-analysis

Hypertension, being a major health issue in Uzbekistan, necessitates an evaluation of novel therapy options like angiotensin-neprilysin receptor inhibitors (ARNIs) relative to conventional therapies. This meta-analysis, by means of systematic review of regional and international databases as well as randomized controlled trials analysis, proved that ARNI therapy was linked to a mean decrease in systolic blood pressure (SBP) of -5.8 mmHg (95% CI: -7.4 to -4.2; P<0.001) and a mean decrease in diastolic blood pressure (DBP) of -2.7 mmHg (95% CI: -3.9 to -1.5; P=0.001) versus usual care. The probability of reaching the blood pressure goal was also significantly higher in the ARNI group (RR=1.18; 95% CI: 1.09-1.28; P<0.001). From a safety point of view, while the risk of major adverse events was overall not tremendously different between the two groups (RR=0.95; 95% CI: 0.84-1.08; P=0.45), symptomatic hypotension was slightly increased in the ARNI group (RR=1.32; 95% CI: 1.02-1.71; P=0.03), while the incidence of adverse events such as angioedema (RR=1.42; 95% CI: 0.76-2.65; P=0.27) and hyperkalemia (RR=1.15; 95% CI: 0.89-1.48; P=0.28) was similar. Results indicate higher efficacy of ARNIs on blood pressure regulation with comparable total safety profile, suggesting their potential application as an effective treatment for the healthcare system of Uzbekistan, but more caution is required in the direction of hypotension.