scholarly journals The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression

2018 ◽  
Vol 15 (8) ◽  
pp. 1789 ◽  
Author(s):  
Edwin F. Liang ◽  
Samuel Z. Lim ◽  
Wilson W. Tam ◽  
Cyrus S. Ho ◽  
Melvyn W. Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Attention Deficit ◽  
Meta Analysis ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Adolescents And Adults ◽  
Meta Regression ◽  
Pre Treatment

Objectives: This meta-analysis aims to study the effects of atomoxetine and methylphenidate on heart rate (HR), systolic blood pressure (SBP), and a number of adverse cardiac events on patients receiving treatment for attention-deficit hyperactive disorder (ADHD) in comparison to placebo and between atomoxetine and methylphenidate. Methods: We searched the following databases: PubMed, EMBASE, and ScienceDirect. Meta-analysis was performed on studies that examined the relationships between methylphenidate or atomoxetine and HR, SBP, as well as a number of adverse cardiac events. These studies were either placebo-controlled or comparison studies between methylphenidate and atomoxetine. Meta-regression identified patient- and treatment-related factors that may contribute to heterogeneity. Results: Twenty-two studies were included and the total number of participants was 46,107. Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo. Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate. Meta-regression revealed mean age of participants, mean dose, and duration of atomoxetine and methylphenidate as significant moderators that explained heterogeneity. There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine. Conclusions: Children/adolescents and adults treated with methylphenidate resulted in significant increases in post- vs. pre-treatment HR and SBP as compared to placebo. Similarly, children and adolescents treated with atomoxetine had significant increases in post- vs. pre-treatment HR and SBP than those treated with methylphenidate. These findings have potential implications for continuous monitoring of HR and SBP throughout the course of treatment although the risk for adverse cardiac events were insignificant.

Abstract 16260: Thirty Days Major Adverse Cardiac Events Following Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Non-ste-acute Coronary Syndrome: A Meta-analysis With Meta-regression

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kiro Barssoum ◽  
Ashish Kumar ◽  
Devesh Rai ◽  
Adnan Kharsa ◽  
Medhat Chowdhury ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
History Of ◽  
Meta Regression ◽  
Meta Regression Analysis

Background: The optimum revascularization modality in multi-vessel and left main disease patients presenting with non-ST elevation acute coronary syndrome (non-STE-ACS) is not well studied. The current recommendations are based on studies that primarily included patients with stable angina. Patients with non-STE-ACS were under-represented in clinical trials. We performed a meta-analysis of studies comparing coronary artery bypass grafting (CABG) vs. percutaneous coronary intervention (PCI) in non-STE-ACS, and reporting 30 days major adverse cardiac events (MACE). Methods: We searched Medline, EmCare, CINAHL, Cochrane database, and Google Scholar for relevant articles. We excluded studies that included patients with stable coronary artery disease and ST elevation myocardial infarction. Our primary outcome was 30 days MACE defined as all-cause death, stroke, repeat revascularization and re-infarction. We used the Paule-Mandel method with the Hartung-Knapp-Sidik-Jonkman adjustment to estimate risk ratio (RR) with a 95% confidence interval (CI). Heterogeneity was assessed using Higgin’s I 2 statistics. To account for heterogeneity, a meta-regression analysis was performed. Results: Five observational studies met our inclusion criteria summing to a total number of 7161 patients. At 30 days, there was no difference between CABG vs. PCI in terms of MACE, RR: 0.96, 95% CI 0.38 to 2.39, I 2 = 81% (Panel A). A meta-regression analysis reported that a history of PCI was associated with a lower risk of MACE with CABG compared to PCI (Panel B). Conclusion: At 30 days, there was no difference in MACE between the CABG and PCI groups. However, a history of PCI was associated with a lower risk of MACE in patients who underwent CABG.

P276 A meta-analysis on the association of febuxostat compared to allopurinol on blood pressure and major adverse cardiac events (MACE) among adult patients with hyperuricemia

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
M Barrientos ◽  
R A Macabeo ◽  
R A Ragasa
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Uric Acid ◽  
Meta Analysis ◽  
Adult Patients ◽  
Cardiac Events ◽  
Lowering Therapy ◽  
Adverse Cardiac Events ◽  
All Cause Mortality

Abstract Background Increased uric acid levels have been known to be associated with different cardiovascular and renal diseases.  Over the last few years, several studies have examined the role of urate-lowering therapy (ULT) in hypertension and Major Adverse Cardiac Events (MACE) and results are pointing to a potential role of elevated serum uric acid as an emerging independent cardiovascular risk factor. Objective  To determine if urate-lowering therapy (Febuxostat vs Allopurinol) has an association on blood pressure and MACE among adult patients with hyperuricemia. Methodology Randomized controlled trials with outcomes of blood pressure, all-cause mortality, myocardial infarction, and stroke were searched through PubMed and Cochrane database. Results Pooled analysis of studies on hyperuricemic patients showed that Febuxostat 40 mg has no significant difference compared with Allopurinol 100/300mg with respect to lowering diastolic (MD -0.56 with 95% CI of -4.28 to 3.15) and systolic blood pressure (MD -0.72 with 95% CI of -4.87 to 6.31).  No significant differences were also noted on all-cause mortality (OR 1.21 with 95% CI of 0.35 to 4.12) and myocardial infarction (MI) (OR 1.38 with 95% CI of 0.19 to 9.94). Outcomes on non-fatal stroke were only reported by Becker, et. al (2010) with only 2 events reported in the Febuxostat 80 mg group (0.26%) and no event in the Allopurinol group (CI= 0.082 to 1.155). Conclusion The results of this meta-analysis showed that urate-lowering therapy (Febuxostat vs Allopurinol) has no significant association on blood pressure among adult patients with hyperuricemia.  No significant association was also found with respect to all-cause mortality and MI. Outcomes on stroke were inconclusive since only one study reported on its events.

The Association of Febuxostat Compared With Allopurinol on Blood Pressure and Major Adverse Cardiac Events Among Adult Patients With Hyperuricemia: A Meta-analysis

2020 ◽  
Vol 76 (4) ◽  
pp. 461-471 ◽  
Author(s):  
Marie Barrientos-Regala ◽  
Renelene A. Macabeo ◽  
Rosemarie Ramirez-Ragasa ◽  
Noemi S. Pestaño ◽  
Felix E. R. Punzalan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Meta Analysis ◽  
Adult Patients ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Adverse Cardiac Events

scholarly journals Post-Operative Blood Pressure in 24 Hours and 3-Year Major Adverse Cardiac Events in Chinese Patients Undergoing PCI

2021 ◽  
Author(s):  
Lijun Gan ◽  
Dandan Sun ◽  
Yuntao Cheng ◽  
Deyang Wang ◽  
Fen Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Linear Relationship ◽  
Diastolic Blood Pressure ◽  
Inflection Point ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Average Systolic Blood Pressure ◽  
Adverse Cardiac Events ◽  
Non Linear

Abstract Background: There is no clear evidence for the target value of blood pressure control within 24 hours after Percutaneous coronary intervention (PCI). Therefore, our study was designed to explore the relationship between blood pressure within 24 hours after PCI and major adverse cardiac events (MACE) during 3-year follow-up. Methods: This study is a prospective study. The study initially collected information of 552 patients. The start and end times of the study are from January 1, 2017 to December 31, 2020. The independent variables of this study are the average systolic blood pressure and the average diastolic blood pressure within 24 hours after PCI. The dependent variable is the occurrence of MACE events in patients within 3 years after PCI. Results: A total of 514 subjects met the inclusion criteria. The average age of the study subjects is 61.92 ± 9.49 years old, of which 67.12% are male. 94 subjects had a MACE event within 3 years, and the occurrence rate was 18.29%. There is no significant non-linear or linear relationship between diastolic blood pressure and MACE events. There is a curvilinear relationship between the average systolic blood pressure within 24 hours of patients after PCI and MACE events within 3 years and the inflection point is 134. On the left side of the inflection point, the effect size and 95% CI are 1.22 and 1.04-1.43, respectively (P=0.017). The impact size and 95% CI at the right inflection point were 0.96 and 0.83-1.11, respectively (P=0.604). Conclusion: There is a non-linear relationship between systolic blood pressure and the occurrence of MACE events in 3 years, and its inflection point is 134mmHg. In the case of ensuring patient safety, we should control the patient's systolic blood pressure within 24 hours after surgery.

scholarly journals Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression

2021 ◽  
Author(s):  
Guilherme Tadeu de Barcelos¹ ◽  
Isabel Heberle¹ ◽  
Juliana Cavestré Coneglian¹ ◽  
Bruno Allan Vieira¹ ◽  
Rodrigo Sudatti Delevatti¹ ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Systolic Blood Pressure ◽  
Aerobic Training ◽  
Data Extraction ◽  
Meta Analysis ◽  
Control Group ◽  
Meta Regression ◽  
Selection Of

Abstract Objective: To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults.Method: The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. Results: Of the 13028 studies found, 24 were selected and included in this review. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p <0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p <0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p <0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). Conclusion: Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.

scholarly journals Effects of music on systolic blood pressure, diastolic blood pressure, and heart rate: a meta-analysis

2012 ◽  
Vol 64 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Rohit S. Loomba ◽  
Rohit Arora ◽  
Parinda H. Shah ◽  
Suraj Chandrasekar ◽  
Janos Molnar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Meta Analysis

scholarly journals Khat (Catha Edulis) as a Risk Factor for Cardiovascular Disorders: Systematic Review and Meta-Analysis

2017 ◽  
Vol 11 (1) ◽  
pp. 146-155 ◽  
Author(s):  
Teshale Ayele Mega ◽  
Nikodimos Eshetu Dabe
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cardiovascular System ◽  
Meta Analysis ◽  
Conclusive Evidence ◽  
Mean Difference ◽  
Cardiovascular Disorders ◽  
Khat Chewing ◽  
The Mean

Background:About 20 million people worldwide are believed to be using khat. Although some studies reported that khat chewing might result in cardiovascular disorders, conclusive evidence is limited.Method:The objective of this review was to synthesize the best available evidence for the effect of khat on the cardiovascular system. Databases searched were PubMed, Cochrane database of systematic reviews, CINAHL, poplin, LILACS, MedNar and Scopus. All papers included in the review were subjected to rigorous appraisal using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. Review Manager Software (Revman 5.3) was used for meta-analysis and effect size and the 95% confidence interval (CI) was calculated.Result:Data was extracted from 10 articles. Our meta-analysis included 9,207 subjects, (2123 chewers and 7084 non-chewers, respectively) to elucidate the effect of khat on heart rate, diastolic and systolic blood pressure. The mean diastolic and systolic blood pressure of khat chewers was higher than the non-chewers with a mean difference of 5.1 mmHg, 95%CI [2.7,7.5] and 7.9 mmHg, 95%CI [2.65, 13.18], respectively. Similarly, the heart rate of the chewers remained consistently higher, making the mean difference of 6.9 beats/min, 95%CI [0.5, 13.3]. In addition, khat was found to have either a causative or worsening effect on stroke, myocardial infarction and heart failure.Conclusion:We showed that khat chewing could significantly affect the cardiovascular system through its effect on heart rate and blood pressure. Therefore, health promotion should be aimed to encourage quitting khat chewing.

scholarly journals High Blood Pressure Variability is an Additional Cardiovascular Risk Factor

2020 ◽  
Vol 16 (1) ◽  
pp. 94-98
Author(s):  
A. V. Rodionov
Keyword(s):  
Blood Pressure ◽  
Calcium Antagonists ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Cardiovascular Complications ◽  
Cardiac Events ◽  
Important Indicator ◽  
Adverse Cardiac Events ◽  
Post Hoc

Blood pressure (BP) is a highly variable physiological indicator. Most people have BP changes within 40-50 mmHg during the day. Various external factors (from the patient’s position during BP measurement to poor adherence to therapy and abuse of short-acting antihypertensive drugs) affect the assessed indicators. Evaluation of the average daily, intra-visit, as well as long-term ("from visit to visit") BP variability is used in clinical practice. In the past twenty years a number of major studies demonstrated that increased BP variability is an independent prognostic factor that increases the risk of cardiovascular complications. The largest meta-analysis of 41 studies showed that an increase in long-term BP variability was associated with 15% and 18% increase in total and cardiovascular mortality, respectively. According to the IDHOCO project, the threshold coefficient of variation for day-today variability is >11.0/12.8. Different groups of antihypertensive drugs have an uneven effect on BP variability. Consistent data from ASCOT-BPLA, X-CELLENT and ACCOMPLISH studies indicate that among the main groups of antihypertensive drugs, calcium antagonists, mainly amlodipine, have the greatest potential for the variability reduction. A decrease in BP variability, as shown in a post-hoc analysis of CAMELOT and PREVENT studies, has a positive effect on the incidence of major adverse cardiac events (MACE). Thus, the BP variability is an important indicator that reflects the prognosis in hypertensive patients. BP variability reduction can be considered as one of the independent goals of therapy. Calcium antagonists can be considered as first-line drugs for patients with high BP variability.

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