scholarly journals The Effect of Electrolytes on Blood Pressure: A Brief Summary of Meta-Analyses

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1362 ◽  
Author(s):  
Sehar Iqbal ◽  
Norbert Klammer ◽  
Cem Ekmekcioglu
Keyword(s):  
Blood Pressure ◽  
Sodium Salt ◽  
Gestational Hypertension ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Blood Pressure Lowering ◽  
Sodium Potassium ◽  
Salt Reduction ◽  
Pressure Lowering ◽  
Meta Analyses

Nutrition is known to exert an undeniable impact on blood pressure with especially salt (sodium chloride), but also potassium, playing a prominent role. The aim of this review was to summarize meta-analyses studying the effect of different electrolytes on blood pressure or risk for hypertension, respectively. Overall, 32 meta-analyses evaluating the effect of sodium, potassium, calcium and magnesium on human blood pressure or hypertension risk were included after literature search. Most of the meta-analyses showed beneficial blood pressure lowering effects with the extent of systolic blood pressure reduction ranging between −0.7 (95% confidence interval: −2.6 to 1.2) to −8.9 (−14.1 to −3.7) mmHg for sodium/salt reduction, −3.5 (−5.2 to −1.8) to −9.5 (−10.8 to −8.1) mmHg for potassium, and −0.2 (−0.4 to −0.03) to −18.7 (−22.5 to −15.0) mmHg for magnesium. The range for diastolic blood pressure reduction was 0.03 (−0.4 to 0.4) to −5.9 (−9.7 to −2.1) mmHg for sodium/salt reduction, −2 (−3.1 to −0.9) to −6.4 (−7.3 to −5.6) mmHg for potassium, and −0.3 (−0.5 to −0.03) to −10.9 (−13.1 to −8.7) mmHg for magnesium. Moreover, sufficient calcium intake was found to reduce the risk of gestational hypertension.

Methodological Aspects of Meta-Analyses Assessing the Effect of Blood Pressure–Lowering Treatment on Clinical Outcomes

Hypertension ◽  
2021 ◽  
Author(s):  
Mattias Brunström ◽  
Costas Thomopoulos ◽  
Bo Carlberg ◽  
Reinhold Kreutz ◽  
Giuseppe Mancia
Keyword(s):  
Blood Pressure ◽  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Research Question ◽  
Blood Pressure Reduction ◽  
Blood Pressure Level ◽  
Blood Pressure Lowering ◽  
Level Of Evidence ◽  
Pressure Lowering ◽  
Meta Analyses

Systematic reviews and meta-analyses are often considered the highest level of evidence, with high impact on clinical practice guidelines. The methodological literature on systematic reviews and meta-analyses is extensive and covers most aspects relevant to the design and interpretation of meta-analysis findings in general. Analyzing the effect of blood pressure–lowering on clinical outcomes poses several challenges over and above what is covered in the general literature, including how to combine placebo-controlled trials, target-trials, and comparative studies depending on the research question, how to handle the potential interaction between baseline blood pressure level, common comorbidities, and the estimated treatment effect, and how to consider different magnitudes of blood pressure reduction across trials. This review aims to address the most important methodological considerations, to guide the general reader of systematic reviews and meta-analyses within our field, and to help inform the design of future studies. Furthermore, we highlight issues where published meta-analyses have applied different analytical strategies and discuss pros and cons with different strategies.

scholarly journals Blood Pressure Lowering for the Prevention of Stroke Recurrence

2010 ◽  
Vol 6 (1) ◽  
pp. 37 ◽  
Author(s):  
Zengwu Wang ◽  
Tom Richart ◽  
Yu Jin ◽  
Jan A Staessen ◽  
Lisheng Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cerebrovascular Disease ◽  
Meta Analysis ◽  
Blood Pressure Reduction ◽  
Previous History ◽  
Stroke Recurrence ◽  
Significant Heterogeneity ◽  
Pressure Reduction ◽  
Blood Pressure Lowering ◽  
Pressure Lowering

Stroke is the second most common cause of mortality worldwide. It is the complication of hypertension that has the most direct link to blood pressure. Hypertension affects nearly 30% of the world’s population. In addition to hypertension, a previous history of cerebrovascular disease is a powerful predictor of stroke recurrence. In a meta-analysis of 10 trials of patients with previous cerebrovascular disease, blood-pressure-lowering treatment reduced systolic blood pressure (ΔSBP) by 5.1mmHg and the risk of stroke recurrence by 22% (p=0.0007) compared with no treatment or placebo. In four trials involving diuretics as a component of therapy (ΔSBP 9.6mmHg), the pooled reduction of stroke recurrence averaged 37% (p<0.0001), whereas it was only 7% in six trials of renin system inhibitors (ΔSBP 4.0mmHg). In metaregression analysis, the weighted correlation co-efficient between the odds for stroke recurrence and the blood pressure reduction was -0.57 (p=0.067). The significant heterogeneity (p<0.0001) between diuretics and renin system inhibitors in the prevention of stroke recurrence might be explained by the greater blood pressure reduction of treatments including diuretics. Our results do not support the use of renin system inhibitors for the prevention of stroke recurrence.

scholarly journals Sex differences in treatment, radiological features and outcome after intracerebral haemorrhage: Pooled analysis of Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials 1 and 2

2020 ◽  
Vol 5 (4) ◽  
pp. 345-350
Author(s):  
Else Charlotte Sandset ◽  
Xia Wang ◽  
Cheryl Carcel ◽  
Shoichiro Sato ◽  
Candice Delcourt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracerebral Haemorrhage ◽  
Blood Pressure Reduction ◽  
Cerebral Haemorrhage ◽  
Pooled Analysis ◽  
Pressure Reduction ◽  
Blood Pressure Lowering ◽  
Scale Scores ◽  
Pressure Lowering ◽  
Intensive Blood Pressure

Introduction Reports vary on how sex influences the management and outcome from acute intracerebral haemorrhage. We aimed to quantify sex disparities in clinical characteristics, management, including response to blood pressure lowering treatment, and outcomes in patients with acute intracerebral haemorrhage, through interrogation of two large clinical trial databases. Patients and Methods Post-hoc pooled analysis of the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials 1 and 2, where patients with a hypertensive response (systolic, 150–220 mmHg) after spontaneous intracerebral haemorrhage (<6 h) were randomised to intensive (target <140 mmHg <1 h) or guideline-recommended (<180 mmHg) blood pressure lowering treatment. The interaction of sex on early haematoma growth (24 h), death or major disability (modified Rankin scale scores 3–6 at 90 days), and effect of randomised treatment were determined in multivariable logistic regression models adjusted for baseline confounding variables. Results In 3233 participants, 1191 (37%) were women who were significantly older, had higher baseline National Institutes of Health Stroke Scale scores and smaller haematoma volumes compared to men. Men had higher three-month mortality (odds ratio 1.48, 95% confidence interval 1.10–2.00); however, there was no difference between women and men in the combined endpoint of death or major disability. There were no significant sex differences on mean haematoma growth or effect of randomised blood pressure lowering treatment. Discussion Men included in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials had more comorbidities, larger baseline haematoma volumes and higher mortality after adjustment for age, as compared with women. Conclusion Men included in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials had a greater odds of dying after intracerebral haemorrhage than women, which could not be readily explained by differing casemix or patterns of blood pressure management. Clinical trial registration The Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials studies are registered with ClinicalTrials.gov (NCT00226096 and NCT00716079).

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