Starry Homenta Rampengan, Derren David Christian Homenta Rampengan, Roy Novri Ramadhan, Sebastian Emmanuel Willyanto, Josh Nathaniel Jowono, Kevin Christian Tjandra, Laksmana Adi Krista Nugraha, Merita Arini
Introduction: This study reviews the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI), nonsteroidal mineralocorticoid receptor antagonists (NMRA), brain rennin-angiotensin system (RAS) therapy, and ribonucleic acid (RNA)-based therapy with evaluating systolic blood pressure and diastolic blood pressure control as well safety by counting adverse events. Methods: Risk of Bias 2.0 were used for quality appraisal and RevMan 5.4 was applied for the meta-analysis. Results: From five databases, 20 articles were selected for review. Six high-risk and fourteen low-risk studies. ARNI and RNA-based therapies improved BP regulation, while NMRA and brain RAS were less effective in managing high blood pressure. In terms of safety, NMRA and RNA-based therapies had fewer adverse events, whereas ARNI and brain RAS had more AEs compared to their control groups. Conclusion: RNA-based therapy outperforms the four antihypertensive drugs studied in terms of efficacy and safety, underscoring its potential as the leading option and justifying further research. © 2025 by Author/s and Licensed by Modestum.
Department of Cardiovascular Medicine, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia; Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia; Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia; Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
