scholarly journals Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m3222 ◽  
Author(s):  
Dongling Luo ◽  
Yunjiu Cheng ◽  
Haifeng Zhang ◽  
Mingchuan Ba ◽  
Pengyuan Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Young Adults ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Risk Difference ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Increased Risk

AbstractObjectiveTo evaluate and quantify the future risk of cardiovascular events in young adults with high blood pressure.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, and Web of Science were searched from inception to 6 March 2020. Relative risks were pooled using a random effects model and expressed with 95% confidence intervals. Absolute risk difference was calculated. Dose-response relations between blood pressure and individual outcomes were assessed by a restricted cubic spline model.Eligibility criteria for selecting studiesStudies were selected that investigated the adverse outcomes of adults aged 18-45 with raised blood pressure. The primary study outcome was a composite of total cardiovascular events. Coronary heart disease, stroke, and all cause mortality were examined as secondary outcomes.ResultsSeventeen observational cohorts consisting of approximately 4.5 million young adults were included in the analysis. The average follow-up was 14.7 years. Young adults with normal blood pressure had increased risk of cardiovascular events compared with those with optimal blood pressure (relative risk 1.19, 95% confidence interval 1.08 to 1.31; risk difference 0.37, 95% confidence interval 0.16 to 0.61 per 1000 person years). A graded, progressive association was found between blood pressure categories and increased risk of cardiovascular events (high normal blood pressure: relative risk 1.35, 95% confidence interval 1.22 to 1.49; risk difference 0.69, 95% confidence interval 0.43 to 0.97 per 1000 person years; grade 1 hypertension: 1.92, 1.68 to 2.19; 1.81, 1.34 to 2.34; grade 2 hypertension: 3.15, 2.31 to 4.29; 4.24, 2.58 to 6.48). Similar results were observed for coronary heart disease and stroke. Generally, the population attributable fraction for cardiovascular events associated with raised blood pressure was 23.8% (95% confidence interval 17.9% to 28.8%). The number needed to treat for one year to prevent one cardiovascular event was estimated at 2672 (95% confidence interval 1639 to 6250) for participants with normal blood pressure, 1450 (1031 to 2326) for those with high normal blood pressure, 552 (427 to 746) for those with grade 1 hypertension, and 236 (154 to 388) for those with grade 2 hypertension.ConclusionsYoung adults with raised blood pressure might have a slightly increased risk of cardiovascular events in later life. Because the evidence for blood pressure lowering is limited, active interventions should be cautious and warrant further investigation.

scholarly journals Gallstone Disease and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Observational Studies

2016 ◽  
Vol 106 (1) ◽  
pp. 21-27 ◽  
Author(s):  
S. Upala ◽  
A. Sanguankeo ◽  
V. Jaruvongvanich
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Gallstone Disease ◽  
Hazard Ratio ◽  
Cross Sectional ◽  
Increased Risk

Objectives: Gallstone disease shares certain risk factors with cardiovascular disease, particularly metabolic risk factors. Patients with gallstone disease may be at increased risk of cardiovascular disease. Several recent studies exploring the effect of gallstone disease on cardiovascular disease outcomes demonstrated inconsistent results. Design: We conducted a systematic review and meta-analysis of cohort, case–control, and cross-sectional studies that compared the risk of developing cardiovascular disease events in patients with gallstone disease versus non-gallstone disease controls. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the pooled hazard ratio, odd ratio, and 95% confidence interval. Results: Data were extracted from six studies involving 176,734 cases and 803,714 controls. The pooled hazard ratio of cardiovascular events in patients with gallstone disease was 1.28 (95% confidence interval: 1.23–1.33, I2 = 42%). The pooled odd ratio of cardiovascular events in patients with gallstone disease was 1.82 (95% confidence interval: 1.47–2.24, I2 = 68%). Conclusions: Our study demonstrated a statistically significant increase in the risk of cardiovascular disease among patients with gallstone disease.

scholarly journals Nurse-Coordinated Blood Pressure Telemonitoring for Urban Hypertensive Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (13) ◽  
pp. 6892
Author(s):  
Woo-Seok Choi ◽  
Nam-Suk Kim ◽  
Ah-Young Kim ◽  
Hyung-Soo Woo
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Intervention Group ◽  
Home Blood Pressure ◽  
Hypertensive Patients ◽  
Increased Risk ◽  
Over Time

Coronavirus disease 2019 (COVID-19) has put hypertensive patients in densely populated cities at increased risk. Nurse-coordinated home blood pressure telemonitoring (NC-HBPT) may help address this. We screened studies published in English on three databases, from their inception to 30 November 2020. The effects of NC-HBPT were compared with in-person treatment. Outcomes included changes in blood pressure (BP) following the intervention and rate of BP target achievements before and during COVID-19. Of the 1916 articles identified, 27 comparisons were included in this review. In the intervention group, reductions of 5.731 mmHg (95% confidence interval: 4.120–7.341; p < 0.001) in systolic blood pressure (SBP) and 2.342 mmHg (1.482–3.202; p < 0.001) in diastolic blood pressure (DBP) were identified. The rate of target BP achievement was significant in the intervention group (risk ratio, RR = 1.261, 1.154–1.378; p < 0.001). The effects of intervention over time showed an SBP reduction of 3.000 mmHg (−5.999–11.999) before 2000 and 8.755 mmHg (5.177–12.334) in 2020. DBP reduced by 2.000 mmHg (−2.724–6.724) before 2000 and by 3.529 mmHg (1.221–5.838) in 2020. Analysis of the target BP ratio before 2010 (RR = 1.101, 1.013–1.198) and in 2020 (RR = 1.906, 1.462–2.487) suggested improved BP control during the pandemic. NC-HBPT more significantly improves office blood pressure than UC among urban hypertensive patients.

scholarly journals Perubahan Kadar Protein dalam Urin terhadap Penggunaan Obat Antihipertensi (Valsartan) pada Pasien Nefropati

2019 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
Selly Septi Fandinata
Keyword(s):  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Metabolic Disorder ◽  
Meta Analysis ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Central Hospital ◽  
Inclusion Criteria ◽  
Chronic Complication

ABSTRAKDiabetes mellitus (DM) adalah suatu sindroma gangguan metabolisme yang dicirikan dengan hiperglikemia abnormal sebagai akibat dari suatu defisiensi sekresi insulin, berkurangnya efektivitas aktivitas biologis insulin atau adanya resistensi insulin. Komplikasi kronik mikrovaskular, salah satunya yaitu Penyakit Ginjal Diabetik. Penyakit Ginjal Diabetik didefinisikan secara klinik yaitu penyakit DM dengan proteinuria yang menetap dalam urin. Meta analisis melaporkan bahwa proteinuria merupakan marker terjadinya kerusakan ginjal. Beberapa penelitian membuktikan bahwa terapi ARB dapat menurunkan derajat proteinuria pada pasien ginjal-diabetik. Terapi ARB yang paling banyak digunakan di RSUD Dr. Sutomo adalah valsartan. Tujuan dari penelitian ini adalah untuk mengetahui perubahan kadar protein dalam urin terhadap penggunaan antihipertensi (valsartan) pada pasien penyakit Nefropati. Penelitian dilakukan di Instalasi Rawat Jalan Penyakit Dalam RSUD Dr. Sutomo. Kriteria Inklusi yaitu penderita penyakit ginjal diabetik di Instalasi rawat jalan dengan proteinuria dan tekanan darah terkontrol (≤130/80mmHg), yang menggunakan terapi antihipertensi tunggal valsartan. Kriteria Eksklusi yaitu hiperkalemia, ISK, menggunakan obat-obatan yang mempengaruhi proteinuria (NSAID, vit B6, B12) dan kontraindikasi terhadap valsartan. Dari penelitian ini disimpulkan bahwa pada pemberian valsartan tidak terjadi perubahan distribusi derajat proteinuria, dari 27 penderita 29,6% mengalami penurunan, 59,26% tetap dan 11,11% mengalami peningkatan derajat proteinuria. Kesimpulan pada penelitian ini bahwa valsartan tidak mengalami perubahan dalam menurunkan deraajat proteinuria.Kata kunci: nefropati, proteinuria, ARB, valsartan. ABSTRACTDiabetes Mellitus (DM) is a syndrome of metabolic disorder characterized by abnormal hyperglicemia. One of the chronic complication DM is renal microangiopathy called Diabetic Nephropathy (DN). In addition, clinical DN is defined as DM with proteinuria. Meta analysis reported proteinuria as a marker of kidney damage as predictor of progressive kidney disease is robust. Moreover several trials concluded ARBs treatment could reduce the level of proteinuria in DN patients. ARBs treatment used in RSUD Dr. Soetomo Central Hospital Surabaya is valsartan. The purpose of this study was to determine the effect of valsartan treatments on the proteinuria level in DN patients. This study was done at the outpatients clinic departement RSUD Dr. Soetomo Central Hospital Surabaya. The inclusion criteria were DN patients with normal blood pressure (≤130/80mmHg). Twenty seven patients were enrolled in this study. The result showed valsartan antiproteinuria, there was no change in proteinuria level distribution. From twenty seven patients 29,6% decreased, 59,26% did not change and 11,11% increased proteinuria level. As a conclusion, valsartan treatment no change in proteinuria level distribution.Keywords: diabetic nephropathy, proteinuria, ARBs, valsartan.

scholarly journals Relation between Age-Related Macular Degeneration and Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Jie Wang ◽  
Yangjing Xue ◽  
Saroj Thapa ◽  
Luping Wang ◽  
Jifei Tang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Macular Degeneration ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Relative Risks ◽  
Age Related ◽  
Increased Risk ◽  
All Cause Mortality

Data on the association between age-related macular degeneration (AMD) and cardiovascular disease and mortality are conflicting. The purpose of this report is to conduct a systematic review to better understand the role of AMD as a risk factor for CVD events and mortality. We searched Medline (Ovid) and Embase (Ovid) for trials published from 1980 to 2015. We included 20 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and cardiovascular events and mortality, involving 29,964,334 participants. In a random-effects model, the adjusted RR (95% confidence interval [CI]) associated with AMD was 1.08 (1.00–1.117) for all-cause mortality (8 studies) and 1.18 (0.98–1.43) for cardiovascular disease mortality (5 studies). The pooled RR (95% CI) was 1.17 (0.94–1.45) for coronary heart disease (CHD; 3 studies) and 1.13 (0.93–1.36) for stroke (8 studies). Findings from this systematic review support that AMD is associated with increased risk of all-cause mortality. The evidence that AMD predicts incident CVD events or CVD mortality remains inclusive and warrants further study in the future.

scholarly journals Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Yalda Bartina ◽  
Mojdeh Larti ◽  
Aliakbar Kiaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Total Sample ◽  
Policy Makers ◽  
Increased Risk ◽  
The World ◽  
Prevalence Of Osteoporosis

Abstract Background Osteoporosis is one of the most common bone system diseases that is associated with an increased risk of bone fractures and causes many complications for patients. With age, the prevalence of this disease increases so that it has become a serious problem among the elders. In this study, the prevalence of osteoporosis among elders around the world is examined to gain an understanding of its prevalence pattern. Methods In this systematic review and meta-analysis, articles that have focused on prevalence of osteoporosis in the world’s elders were searched with these key words, such as Prevalence, Osteoporosis, Elders, Older adult in the Science Direct, Embase, Scopus, PubMed, Web of Science (WoS) databases and Google Scholar search engine, and extracted without time limit until March 2020 and transferred to information management software (EndNote). Then, duplicate studies were eliminated and the remaining studies were evaluated in terms of screening, competence and qualitative evaluation based on inclusion and exclusion criteria. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2) and Begg and Mazumdar test was used to check the publication bias and I2 test was used to check the heterogeneity. Results In a review of 40 studies (31 studies related to Asia, 5 studies related to Europe and 4 studies related to America) with a total sample size of 79,127 people, the prevalence of osteoporosis in the elders of the world; 21.7% (95% confidence interval: 18.8–25%) and the overall prevalence of osteoporosis in older men and women in the world, 35.3% (95% confidence interval: 27.9–43.4%), 12.5% (95% confidence interval: 9.3–16.7%) was reported. Also, the highest prevalence of osteoporosis in the elders was reported in Asia with; 24.3% (95% confidence interval: 20.9–28.1%). Conclusion The results of the present study showed that the prevalence of osteoporosis in the elders and especially elders' women is very high. Osteoporosis was once thought to be an inseparable part of elders’ lives. Nowadays, Osteoporosis can be prevented due to significant scientific advances in its causes, diagnosis, and treatment. Regarding the growing number of elderly people in the world, it is necessary for health policy-makers to think of measures to prevent and treat osteoporosis among the elders.

PROGNOSIS OF DIFFERENTIATED THYROID CARCINOMA IN PATIENTS WITH GRAVES DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2019 ◽  
Vol 25 (12) ◽  
pp. 1323-1337 ◽  
Author(s):  
Poemlarp Mekraksakit ◽  
Pattara Rattanawong ◽  
Rudruidee Karnchanasorn ◽  
Chanavuth Kanitsoraphan ◽  
Natnicha Leelaviwat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Thyroid Carcinoma ◽  
Cancer Diagnosis ◽  
Distant Metastasis ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Differentiated Thyroid Carcinoma ◽  
Graves Disease ◽  
Increased Risk

Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I 2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I 2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone

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