A systematic review including 24 studies with a total of 1,285 subjects was abstracted in DARE. Pseudoephedrine was found to cause a statistically significant increase in systolic blood pressure (WMD 0.99 mmHg, 95% CI: 0.08 to 1.90) and heart rate (2.83 beats/minute, 95% CI: 2.03 to 3.63) compared with placebo. The increase in diastolic BP was not statistically significant (0.63 mmHg, 95% CI: -0.10 to 1.35). No clinically significant adverse events were reported.
Comment: The quality of evidence is downgraded by the possibility of publication bias. There is a possibility that the effect of pseudoephedrine may have been overestimated, partly due to the exclusion of 21 studies that reported no effect of pseudoephedrine but were excluded because they did not report extractable outcome data.