The quality of evidence is downgraded by inconsistency (variability in results), by indirectness (differences between outcomes of interest and those studied: only short-term outcomes reported), and by imprecise results (few patients).
A Cochrane review [Abstract] 1 included 3 studies with a total of 211 subjects with hypertension or prehypertension, plus hyperuricaemia. The aim of this review was to determine whether or not treatment for hyperuricemia also results in a reduction of blood pressure (BP) in prehypertensive or hypertensive patients.
No significant differences were observed in 24-hour ambulatory systolic (MD -6.2 mmHg, 95% CI -12.8 to 0.5; 3 studies, n=229) or diastolic BP (-3.9 mmHg, 95% CI -9.2 to 1.4; 3 studies, n=229) between those who received uric acid (UA)-lowering drugs and placebo.UA-lowering drugs reduced clinic-measured systolic BP (-8.43 mmHg, 95% CI -15.24 to -1.62; 2 studies, n=120) but results for clinic-measured diastolic BP were inconclusive (-6.45 mmHg, 95% CI -13.60 to 0.70; 2 studies, n=120).Serum UA levels were reduced by 3.1 mg/dL (95% CI 2.4 to 3.8; 3 studies, n=223) in the participants that received UA-lowering drugs.Results were inconclusive regarding the occurrence of adverse events between those who received UA-lowering drugs and placebo (RR 1.86, 95% CI 0.43 to 8.10; 3 studies, n=241).
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