Dataset Information

Prehypertension and incidence of cardiovascular disease: a meta-analysis.

ABSTRACT: BACKGROUND: Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors. This meta-analysis evaluated the association between prehypertension and CVD morbidity. METHODS: Databases (PubMed, EMBASE and the Cochrane Library) and conference proceedings were searched for prospective cohort studies with data on prehypertension and cardiovascular morbidity. Two independent reviewers assessed the reports and extracted data. The relative risks (RRs) of CVD, coronary heart disease (CHD) and stroke morbidity were calculated and reported with 95% confidence intervals (95% CIs). Subgroup analyses were conducted on blood pressure, age, gender, ethnicity, follow-up duration, number of participants and study quality. RESULTS: Pooled data included the results from 468,561 participants from 18 prospective cohort studies. Prehypertension elevated the risks of CVD (RR = 1.55; 95% CI = 1.41 to 1.71); CHD (RR = 1.50; 95% CI = 1.30 to 1.74); and stroke (RR = 1.71; 95% CI = 1.55 to 1.89). In the subgroup analyses, even for low-range prehypertension, the risk of CVD was significantly higher than for optimal BP (RR = 1.46, 95% CI = 1.32 to 1.62), and further increased with high-range prehypertension (RR = 1.80, 95% CI = 1.41 to 2.31). The relative risk was significantly higher in the high-range prehypertensive populations than in the low-range populations (?2= 5.69, P = 0.02). There were no significant differences among the other subgroup analyses (P>0.05). CONCLUSIONS: Prehypertension, even in the low range, elevates the risk of CVD after adjusting for multiple cardiovascular risk factors.

SUBMITTER: Huang Y

PROVIDER: S-EPMC3750349 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Prehypertension and incidence of cardiovascular disease: a meta-analysis.

Huang Yuli Y Wang Sheng S Cai Xiaoyan X Mai Weiyi W Hu Yunzhao Y Tang Hongfeng H Xu Dingli D

BMC medicine 20130802

<h4>Background</h4>Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors. This meta-analysis evaluated the association between prehypertension and CVD morbidity.<h4>Methods</h4>Databases (PubMed, EMBASE and the Cochrane Library) and conference proceedings were searched for prospective cohort studies with data on prehypertension and cardiovascular morbidity. Two independent reviewers ...[more]

PMID: 23915102

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Project description:ContextPrevious meta-analyses evaluating the association between nut consumption and the risk of cardiovascular disease (CVD) had substantial methodological limitations and lacked recently published large prospective studies; hence, making an updated meta-analysis highly desirable.ObjectiveTo update the clinical guidelines for nutrition therapy in relation to the European Association for the Study of Diabetes (EASD), a systematic review and meta-analysis of prospective studies was conducted using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to summarize the evidence of the association between total nuts, specific types of nuts, and the incidence of, and mortality from, CVD outcomes.Data sourcesRelevant articles were identified by searching the PubMed and Cochrane databases.Data extractionTwo independent researchers screened the articles to identify those that met the inclusion criteria.Data analysisThe inverse variance method with fixed-effect or random-effects models was used to pool data across studies (expressed as risk ratio [RR] and 95% confidence interval [CI]). Heterogeneity was tested and quantified using the Cochrane Q test and I2-statistic, respectively. The GRADE system was used to assess the quality of the evidence.ResultsNineteen studies were included in the analyses. The results revealed an inverse association between total nut consumption (comparing highest vs lowest categories) and CVD incidence (RR, 0.85; 95%CI, 0.800.91; I2,?0%), CVD mortality (RR, 0.77; 95%CI, 0.72-0.82; I2,?3%), coronary heart disease (CHD) incidence (RR, 0.82; 95%CI, 0.69-0.96; I2,?74%), CHD mortality (RR, 0.76; 95%CI, 0.67-0.86; I2,?46%), stroke mortality (RR, 0.83; 95%CI, 0.75-0.93; I2,?0%), and atrial fibrillation (RR, 0.85; 95%CI, 0.73-0.99; I2,?0%). No association was observed with stroke incidence and heart failure. The certainty of the evidence ranged from moderate to very low.ConclusionsThis systematic review and meta-analysis revealed a beneficial role of nut consumption in reducing the incidence of, and mortality from, different CVD outcomes.

Project description:BACKGROUND/OBJECTIVES:Population-based incidence estimates of dementia and Alzheimer disease (AD) provide important information for public health policy and resource allocation. We conducted a meta-analysis of published studies that reported age-specific incidence rates of dementia and AD to determine whether dementia and AD incidence rates are changing over time. DESIGN:PubMed and MEDLINE were searched for publications through June 30, 2017, using key words "dementia", "Alzheimer", and "incidence." Inclusion criteria for the meta-analysis are: (1) population-based studies using personal interviews and direct examinations of the study subjects, (2) standardized clinical diagnosis criteria, (3) reporting age-specific incidence rates, (4) published in English, and (5) sample size of 500 or greater and length of follow-up of 2 years or greater. Mixed-effects models were used to determine the association between birth year and incidence rates. MEASUREMENTS:Age-specific dementia/AD incidence rates and their standard errors reported in each study. RESULTS:Thirty-eight articles with 53 cohorts on dementia incidence and 31 articles with 35 cohorts on AD incidence met the inclusion criteria. There were significant associations between later birth years and decreased dementia incidence rates in all three age groups (65-74, 75-84, and 85 years and older). There were no significant associations between birth year and AD incident rates in any of the three age groups. In particular, AD incidence rates reported from Western countries stayed steady in all age groups, while studies in non-Western countries showed significantly increased AD incidence rates for the 65 to 74 years age group (odds ratio = 2.78; P =?.04), but a nonsignificant association for the 75 to 84 or 85 years and older groups. CONCLUSION:Dementia incidence declined over the past four decades, but AD incidence did not decline. Further research, especially from non-Western countries, is needed to elucidate the mechanism underlying the trends in dementia and AD incidence over time.

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Prehypertension and incidence of cardiovascular disease: a meta-analysis.

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Prehypertension and incidence of cardiovascular disease: a meta-analysis.

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