EFFICACY OF AMLODIPINE VS. ENALAPRIL IN MANAGING HYPERTENSION AMONG ATHLETES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective: To assess the efficacy and safety of amlodipine compared to enalapril in managing hypertension among athletes. Methods: A thorough literature search was conducted in PubMed, the Cochrane Library, and Web of Science through May 2022. We focused on studies comparing the effects of amlodipine and enalapril on systolic and diastolic blood pressure reduction, their impact on athletic performance, and side effects in hypertensive athletes. Data were synthesized using weighted mean differences (WMD) and relative risks (RR) with 95% confidence intervals (CIs), applying both fixed- and random-effects meta-analyses depending on the I² statistic values for heterogeneity. Results: Nine randomized controlled trials involving 1080 participants were included in this meta-analysis. Both amlodipine and enalapril were effective in reducing systolic and diastolic blood pressure without significant differences between them in general hypertension management among athletes. Subgroup analyses highlighted that amlodipine significantly enhanced systolic blood pressure reduction (WMD, -15.30; 95% CI, -21.71 to -8.89) compared to enalapril, particularly in athletes. Moreover, the side effects profile between the two drugs did not show significant differences, indicating comparable safety. Conclusion: Amlodipine and enalapril are both effective and safe in managing hypertension in athletes. However, amlodipine may offer superior systolic blood pressure control, suggesting a potential preference for this drug in hypertensive athletes seeking to maintain optimal sports performance while managing their condition.