Effects of selective Imidazolin-1 (I1) receptor agonists vs ACE- Is/ARBs on metabolic parameters in patients of hypertension: A Meta-analysis of RCTs

Objectives: Co-existence of metabolic syndrome in hypertensive patients is associated with the higher risk for development of various complications including type 2 diabetes mellitus and hence highlights the need for selecting an anti-hypertensive with favorable effect on metabolic parameters. Present study aims at analyzing the efficacies of selective imidazolin-1 (I1) receptor agonists vs ACE-Is/ARBs on blood pressure, indicators of insulin resistance and plasma lipids concentration. Methods: Electronic data search in PUBMED, Cochrane library and EMBASE was conducted. Eligible studies were analyzed by random and fixed effects model for the effect size measures. RevMan 5.2 software was used for statistical analysis Results: There was significant difference in the level of decrease in total cholesterol and triglyceride in imidazolins group. However, the decrease in systolic and diastolic blood pressure was significantly more in ACE-Is/ARBs. However among these significant findings found in fixed effect model, the only significant change present in random effect model was the decrease in triglycerides by imidazolins. Conclusion: Efficacy of I1-agonists on plasma lipids and decreasing blood pressure appears to be non-inferior to ACE-Is/ARBs at short term treatment.