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High Blood Pressure & Cardiovascular Prevention

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09-12-2023 | Allopurinol | Review article

Efficacy of Allopurinol in Improving Endothelial Dysfunction: A Systematic Review and Meta-Analysis

Authors: Shurjeel Uddin Qazi, Usama Qamar, Muhammad Talha Maqsood, Rabbia Gul, Saad Ali Ansari, Zeeshan Imtiaz, Amatul Noor, Mahammed Zia Khan Suheb, Zaofashan Zaheer, Adeela Andleeb, Masooma Naseem, Muhammad Shariq Akram, Mubarak Ali, Alina Barmanwalla, Rutab Tareen, Irfa Zaheer

Published in: High Blood Pressure & Cardiovascular Prevention | Issue 6/2023

Abstract

Introduction

Endothelial dysfunction has been implicated in various cardiovascular disorders as the initial pathology. Allopurinol has been shown to improve endothelial dysfunction in patients with gout, but its effect on cardiovascular patients is unclear.

Aims

We aim to assess allopurinol efficacy in improving endothelial dysfunction overall and in different disease states including but not limited to heart failure, chronic kidney disease, ischemic heart disease

Methods

We conducted a literature search of PubMed, Cochrane’s Central Library, and Scopus until December 2022, including randomized controlled trials and double-arm observational studies. The primary outcome measure was endothelial function assessed by change in flow mediated dilation (FMD)

Results

Our meta-analysis included 22 studies with a total of 1472 patients. Our pooled analysis shows that allopurinol significantly improved FMD (WMD = 1.46%, 95% CI [0.70, 2.22], p < 0.01) compared to control. However, there was no significant difference between allopurinol and control for endothelial-independent vasodilation measured by forearm blood flow (WMD = 0.10%, 95% CI [− 0.89, 0.69], p = 0.80). Subgroup analysis indicated that the effect of allopurinol on FMD was more significant in diabetic and congestive heart failure patients.

Conclusion

While allopurinol may improve endothelial function in various patient populations, further high-quality randomized controlled trials are needed to determine its efficacy in preventing cardiovascular disease exacerbation.

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Title: Efficacy of Allopurinol in Improving Endothelial Dysfunction: A Systematic Review and Meta-Analysis
Authors: Shurjeel Uddin Qazi
Usama Qamar
Muhammad Talha Maqsood
Rabbia Gul
Saad Ali Ansari
Zeeshan Imtiaz
Amatul Noor
Mahammed Zia Khan Suheb
Zaofashan Zaheer
Adeela Andleeb
Masooma Naseem
Muhammad Shariq Akram
Mubarak Ali
Alina Barmanwalla
Rutab Tareen
Irfa Zaheer
Publication date: 09-12-2023
Publisher: Springer International Publishing
Keywords: Allopurinol
Chronic Kidney Disease
Published in: High Blood Pressure & Cardiovascular Prevention / Issue 6/2023
Print ISSN: 1120-9879
Electronic ISSN: 1179-1985
DOI: https://doi.org/10.1007/s40292-023-00615-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of Allopurinol in Improving Endothelial Dysfunction: A Systematic Review and Meta-Analysis

Abstract

Introduction

Aims

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Aims

Methods

Results

Conclusion

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