CONTEXT: Systemic arterial hypertension is part of the metabolic syndrome resulting from obesity. OBJECTIVE:To evaluate the effect of sibutramine on overweight and obese patients' blood pressure through a systematic review. METHODS:All the studies included needed to be randomized controlled trials. The methodological quality of the selected trials was assessed using the criteria described in the Cochrane Handbook. The participants were overweight and obese patients; the intervention was sibutramine compared with placebo. The primary outcome measurement was systolic and diastolic blood pressure and the secondary measurement was blood pressure. Studies were identified by searching the following sources: Literatura LatinoAmericana e do Caribe em Ciências da Saúde (Lilacs), Medline, Cochrane reviews, manual searches, personal communication and contact with the pharmaceutical industry. There were no language, date or other restrictions. Data collection and extraction was performed by two reviewers, who independently obtained the full articles of all eligible papers.RESULTS: Three meta-analyses were produced: 1) systolic blood pressure outcome (eight studies) did not show statistical signifi cance between sibutramine and placebo: weighted mean difference (WMD) 1.57, confi dence interval (CI) -0.03 to 3.18; 2) diastolic blood pressure outcome (ten studies) did not show statistical signifi cance between sibutramine and placebo: WMD 1.13, CI -0.49 to 2.76; 3) blood pressure outcome (two studies) also did not show statistical signifi cance between the groups: relative risk (RR) 0.69, CI 0.07 to 7.01. CONCLUSIONS:The meta-analyses presented in this systematic review show that sibutramine does not have a statistically signifi cant effect on blood pressure, compared with placebo.

CONTEXT AND OBJECTIVE: Cardiac resynchronization therapy (CRT) has emerged as the predominant electrical treatment strategy for patients on pharmacological therapy who present heart failure with wide QRS and low ejection fraction. The objective of this study was to investigate whether cardiac resynchronization therapy improved mortality and morbidity among patients with heart failure. METHODS:This was a systematic review using the Cochrane Collaboration's methodology. The online search strategy included the Cochrane Library, Medline (Medical Literature Analysis and Retrieval System Online), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) and cardiology congresses from 1990 to 2006. The criteria for considering studies for this review were as follows:-types of studies: randomized controlled trials; types of interventions: cardiac resynchronization therapy compared with other therapies; types of participants: patients with heart failure with low ejection fraction and wide QRS; outcomes: death or hospitalization.RESULTS: Seven trials met the selection criteria. The risk of death due to congestive heart failure was nonsignificant: relative risk (RR), 0.79; 95% confidence interval (CI): 0.60 to 1.03. There was an absolute risk reduction of 4% in all-cause mortality for the experimental group [RR 0.70; CI: 0.60 to 0.83; number needed to treat (NNT) 25]; sudden cardiac death showed a statistically significant difference favoring the experimental group, with absolute risk reduction of 1% (CI: 0.46 to 0.96; RR 0.67; NNT 100). There was an absolute risk reduction of 9% for hospitalization due to heart failure (RR 0.64; CI: 0.50 to 0.80; NNT 11) in the experimental group. CONCLUSIONS:Patients receiving CRT had a significantly lower risk of hospitalization due to heart failure, but death rates due to heart failure were similar. RESUMOCONTEXTO E OBJETIVO: A terapia de ressincronização cardíaca (TRC) surgiu como a estratégia de tratamento elétrico predominante para pacientes com insuficiência cardíaca com QRS largo e baixa fração de ejeção. O objetivo foi investigar se a terapia de ressincronização cardíaca melhora a mortalidade e morbidade dos pacientes com insuficiência cardíaca. MÉTODOS:

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CONTEXT AND OBJECTIVE:The safety and effi cacy of drug-eluting stents reduce the need for surgical revascularization. The objective of the present study was to investigate whether paclitaxel or rapamycin-eluting stent are effective in avoiding the need for coronary-artery bypass grafting. METHODS:This was a systematic review of the literature using the methodology of the Cochrane Collaboration. The type of study considered was controlled randomized trials; the type of intervention was drug-eluting or bare-metal stents; and the main outcome investigated was coronary-artery bypass grafting. RESULTS:The ten studies included in this systematic review did not show any statistically signifi cant difference between the drug-eluting stents and the bare-metal stents with regard to the outcome of coronary-artery bypass grafting (confi dence interval: 0.31 to 1.42). CONCLUSION:The surgical revascularization rate was not reduced by the use of drug-eluting stents.