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The Journal of Maternal-fetal &... Apr 2020Emerging evidence shows that high blood pressure (BP) level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant... (Meta-Analysis)
Meta-Analysis
Emerging evidence shows that high blood pressure (BP) level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant complications. The meta-analysis evaluated the associations between prehypertension (BP 120-139/80-89 mmHg) during pregnancy and the risk of small for gestational age (SGA), as well as the impact of prehypertension on birth weight (BW). Databases (PubMed, Embase, and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including SGA and/or BW. The relative risks (RRs) of SGA and weighted mean differences (WMD) in BW were calculated and reported with 95% confidence intervals (95% CIs). We calculated pooled RRs using fixed- and random-effects models. A total of 143,835 participants from five cohort studies were included. Prehypertension in pregnancy increased the risk of SGA (RR 1.59, 95%CI 1.44 to 1.76, < .00001) and lowered BW (WMD -13.71, 95% CI -83.28 to 55.87, = .70) compared with optimal BP (<120/80 mmHg). In subgroup analyses, for prehypertension in late pregnancy, the risk of SGA was significantly higher than for optimal BP (RR 1.60, 95% CI 1.44 to 1.78). BP within the range of 120-139/80-89 mmHg during pregnancy, as previously defined as prehypertension, particularly in late pregnancy, was associated with a 59% increase in the risk of having an SGA birth.
Topics: Birth Weight; Female; Humans; Infant, Small for Gestational Age; Pregnancy; Pregnancy Complications, Cardiovascular; Prehypertension; Risk Assessment
PubMed: 30173597
DOI: 10.1080/14767058.2018.1519015 -
Journal of Clinical Medicine Sep 2019The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT).... (Review)
Review
The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2-3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.
PubMed: 31492032
DOI: 10.3390/jcm8091393 -
TheScientificWorldJournal 2021Prehypertension is a precursor for developing hypertension and is a risk factor for cardiovascular diseases. Yoga therapy may have a role in lowering the blood pressures... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Prehypertension is a precursor for developing hypertension and is a risk factor for cardiovascular diseases. Yoga therapy may have a role in lowering the blood pressures in prehypertension and hypertension. This systematic review aims to synthesize the available literature for the same. . Databases such as PubMed, Embase, Scopus, and Web of Science were searched for randomised control trials only in the time duration of 2010-2021. The main outcome of interest was systolic and diastolic blood pressures. Articles were screened based on the inclusion criteria, and 8 articles were recruited for the review. Meta-analysis was done for suitable articles. RevMan 5.4 by Cochrane was used for meta-analysis and forest plot construction. Risk of bias was determined using the Downs and Black checklist by three independent authors.
RESULTS
The meta-analysis of the articles favoured yoga intervention over the control intervention. Yoga therapy had significantly reduced the systolic pressure (-0.62 standard mean difference, at IV fixed 95% CI: -0.83, -0.41) and diastolic pressure (-0.81 standard mean difference, at IV random 95% CI: -1.39, -0.22). Secondary outcome measures studied were heart rate, weight, BMI, waist circumference, and lipid profile. The main protocol of yoga therapy included postures, breathing exercises, and different meditation techniques. A significant reduction in secondary outcomes was observed, except for HDL values in lipid profile which showed a gradual increase in yoga group in comparison with alternative therapy.
CONCLUSION
Yoga therapy has shown to be significant in the reduction of systolic and diastolic pressure in prehypertensive population. Supporting evidence lacks in providing a proper structured dosage of yoga asanas and breathing techniques. Considering the existing literature and evidence, Yoga therapy can be used and recommended in prehypertensive population and can be beneficial in reducing the chances of developing hypertension or cardiovascular diseases.
Topics: Blood Pressure; Breathing Exercises; Humans; Prehypertension; Vagus Nerve; Yoga
PubMed: 34552393
DOI: 10.1155/2021/4039364 -
Frontiers in Public Health 2022This study aims to compare the potential short-term effects of non-pharmacological interventions (NPIs) on prehypertensive people, and provide evidence for intervention... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study aims to compare the potential short-term effects of non-pharmacological interventions (NPIs) on prehypertensive people, and provide evidence for intervention models with potential in future community-based management.
METHODS
In this Bayesian network meta-analysis, Pubmed, Embase, and Web of science were screened up to 16 October 2021. Prehypertensive patients (systolic blood pressure, SBP 120-139 mmHg/diastolic blood pressure, DBP 80-89 mmHg) with a follow-up period longer than 4 weeks were targeted. Sixteen NPIs were identified during the scope review and categorized into five groups. Reduction in SBP and DBP was selected as outcome variables and the effect sizes were compared using consistency models among interventions and intervention groups. Grade approach was used to assess the certainty of evidence.
RESULTS
Thirty-nine studies with 8,279 participants were included. For SBP, strengthen exercises were the most advantageous intervention group when compared with usual care (mean difference = -6.02 mmHg, 95% CI -8.16 to -3.87), and combination exercise, isometric exercise, and aerobic exercise were the three most effective specific interventions. For DBP, relaxation was the most advantageous intervention group when compared with usual care (mean difference = -4.99 mmHg, 95% CI -7.03 to -2.96), and acupuncture, meditation, and combination exercise were the three most effective specific interventions. No inconsistency was found between indirect and direct evidence. However, heterogeneity was detected in some studies.
CONCLUSION
NPIs can bring short-term BP reduction benefits for prehypertensive patients, especially exercise and relaxation. NPIs could potentially be included in community-based disease management for prehypertensive population once long-term real-world effectiveness and cost-effectiveness are proven.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=151518, identifier: CRD42020151518.
Topics: Humans; Blood Pressure; Bayes Theorem; Network Meta-Analysis; Hypertension; Exercise Therapy
PubMed: 36711409
DOI: 10.3389/fpubh.2022.1051581 -
American Journal of Health-system... Jan 2020To systematically summarize evidence from multiple systematic reviews (SRs) examining interventions addressing medication nonadherence and to discern differences in...
PURPOSE
To systematically summarize evidence from multiple systematic reviews (SRs) examining interventions addressing medication nonadherence and to discern differences in effectiveness by intervention, patient, and study characteristics.
SUMMARY
MEDLINE, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects were searched for papers published from January 2004 to February 2017. English-language SRs examining benefits of medication adherence interventions were eligible. Inclusion was limited to adult patients prescribed medication for 1 of the following disease conditions: diabetes and prediabetes, heart conditions, hypertension and prehypertension, stroke, and cognitive impairment. Non-disease-specific SRs that considered medication adherence interventions for older adults, adults with chronic illness, and adults with known medication adherence problems were also included. Two researchers independently screened titles, abstracts, and full-text articles. They then extracted key variables from eligible SRs, reconciling discrepancies via discussion. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess SRs; those with scores below 8 were excluded. Conclusions regarding intervention effectiveness were extracted. Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology was applied to assess evidence quality.
RESULTS
Of 390 SRs, 25 met the inclusion criteria and assessed adherence as a primary outcome. Intervention types most consistently found to be effective were dose simplification, patient education, electronic reminders to patients, and reduced patient cost sharing or incentives. Of 50 conclusions drawn by the SRs, the underlying evidence was low or very low quality for 45 SRs.
CONCLUSION
Despite an abundance of primary studies and despite only examining high-quality SRs, the vast majority of primary studies supporting SR authors' conclusions were of low or very low quality. Nonetheless, health system leaders seeking to improve medication adherence should prioritize interventions that have been studied and found to be effective at improving patient adherence, including dose simplification, education, reminders, and financial incentives.
Topics: Humans; Medication Adherence; Systematic Reviews as Topic
PubMed: 31901098
DOI: 10.1093/ajhp/zxz284 -
Journal of Hypertension Dec 2019To assess the association of prehypertension (SBP 120-139 mmHg and/or DBP 80-89 mmHg) and total cardiovascular diseases (CVDs), coronary heart disease (CHD),... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the association of prehypertension (SBP 120-139 mmHg and/or DBP 80-89 mmHg) and total cardiovascular diseases (CVDs), coronary heart disease (CHD), myocardial infarction (MI), and stroke.
METHODS
PubMed, Embase, and Web of Science were searched for articles published up to 7 November 2018. Normal range BP was considered SBP less than 120 mmHg and DBP less than 80 mmHg. RRs and 95% CIs were pooled using fixed-effects models. Meta-regression was conducted to estimate the heterogeneity among subgroups.
RESULTS
We included 27 articles (47 studies including 491 666 study participants) in the analysis. Prehypertension was associated with total CVDs (RR 1.40, 95% CI 1.34-1.46), CHD (1.40, 1.28-1.52), MI (1.86, 1.50-2.32), and stroke (1.66, 1.56-1.76). Risk of total CVDs, MI, and stroke was increased with low-range prehypertension (low-range: SBP 120-129 mmHg and/or DBP 80-84 mmHg) versus normal BP - RR 1.42 (95% CI 1.29-1.55), 1.43 (1.10-1.86), and 1.52 (1.27-1.81), respectively - and risk of total CVDs, CHD, MI, and stroke was increased with high-range prehypertension (high-range: SBP 130-139 mmHg and/or DBP 85-89 mmHg) - RR 1.81 (95% CI 1.56-2.10), 1.65 (1.13-2.39), 1.99 (1.59-2.50), and 1.99 (1.68-2.36), respectively. The population-attributable risk for the association of total CVDs, CHD, MI, and stroke with prehypertension was 12.09, 13.26, 24.60, and 19.15%, respectively.
CONCLUSION
Prehypertension, particularly high-range, is associated with increased risk of total CVDs, CHD, MI, and stroke. Effective control of prehypertension could prevent more than 10% of CVD cases.
Topics: Cardiovascular Diseases; Humans; Prehypertension; Risk Factors
PubMed: 31335511
DOI: 10.1097/HJH.0000000000002191 -
PeerJ 2021This systematic review and meta-analysis aimed to determine the effectiveness of olive leaf extract on cardiometabolic profiles among prehypertensive and hypertensive...
BACKGROUND
This systematic review and meta-analysis aimed to determine the effectiveness of olive leaf extract on cardiometabolic profiles among prehypertensive and hypertensive groups.
METHODOLOGY
The Cochrane central register of controlled trials, Medline (1966 to April week 1, 2020), Embase (1966 to April week 1, 2020) and trial registries for relevant randomized clinical trials were used. Published and unpublished randomized clinical trials were reviewed and evaluated. Random effects models were used to estimate the continuous outcomes and mean differences (MDs); both with 95% confidence intervals (CIs). The primary outcomes were changes in systolic and diastolic BP. The secondary outcomes were changes in lipid profile, glucose metabolism, inflammatory markers for CVD, kidney and liver functions safety parameters. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias and quality of evidence.
RESULTS
Five trials were included involving 325 patients aged 18-80 years. Two trials involved high-income countries and three trials involved moderate-income countries. The analysis performed was based on three comparisons. No significant changes were found between systolic or diastolic blood pressure (BP) for the first comparison, 1,000 mg per day for a combined formulation of olive leaf extract versus a placebo. The second comparison, 500 mg per day of olive leaf extract versus placebo or no treatment, showed a significant reduction in systolic BP over a period of at least 8 weeks of follow up (MD -5.78 mmHg, 95% CI [-10.27 to -1.30]) and no significant changes on diastolic BP. The third comparison, 1,000 mg per day of olive leaf extract versus placebo shows no significant difference but an almost similar reduction in systolic BP (-11.5 mmHg in olive leaf extract and -13.7 mmHg in placebo, MD 2.2 mmHg, 95% CI [-0.43-4.83]) and diastolic BP (-4.8 mmHg in olive leaf extract and -6.4 mmHg in placebo, MD 1.60 mmHg, 95% CI [-0.13-3.33]). For secondary outcomes, 1,000 mg per day of olive leaf extract versus captopril showed a reduction in LDL (MD -6.00 mg/dl, 95% CI [-11.5 to -0.50]). The 500 mg per day olive leaf extract versus placebo showed a reduction in inflammatory markers for CVD IL-6 (MD -6.83 ng/L, 95% CI [-13.15 to -0.51]), IL-8 (MD -8.24 ng/L, 95% CI [-16.00 to -0.48) and TNF-alpha (MD -7.40 ng/L, 95% CI [-13.23 to -1.57]).
CONCLUSIONS
The results from this review suggest the reduction of systolic BP, LDL and inflammatory biomarkers, but it may not provide a robust conclusion regarding the effects of olive leaf extract on cardiometabolic profile due to the limited number of participants in the included trials.
REVIEW REGISTRATIONS
PROSPERO CDR 42020181212.
PubMed: 33868820
DOI: 10.7717/peerj.11173 -
Obesity Research & Clinical Practice 2021This systematic review aimed to investigate the association between VAI and blood pressure. (Review)
Review
PURPOSE
This systematic review aimed to investigate the association between VAI and blood pressure.
METHODS
The study was according to the PRISMA standards and the bibliographic search in the PubMed, EMBASE and Cochrane Library databases.
RESULTS
This review included 32 articles, with 60,482 individuals - children to elderly people between 7 and 102 years old - of different age groups, most of them female (54.9%; n = 26,478). The year of publication ranged from 2010 to 2020, indicating that it is a recent theme, applied in almost all continents (America, Europe, Africa and Asia). The authors used data as continuous or into quantiles; blood pressure data also varied, with different cutoff points for the classification of arterial hypertension or continuously. The vast majority of studies have shown a positive association between VAI and blood pressure, both the sexes, in different age groups. The evaluation of the quality of the articles used by the Tool of the Joanna Briggs Institute according to their design.
CONCLUSION
Individuals with increased VAI have higher blood pressure levels. Registration (PROSPERO: CRD42020205965).
Topics: Adiposity; Adolescent; Adult; Aged; Aged, 80 and over; Blood Pressure; Child; Female; Humans; Hypertension; Intra-Abdominal Fat; Middle Aged; Obesity, Abdominal; Young Adult
PubMed: 34696990
DOI: 10.1016/j.orcp.2021.10.001 -
The Journal of Maternal-fetal &... Dec 2024Maternal high blood pressure (BP) was associated with adverse pregnancy outcomes. This study aimed to synthesize evidence on the association between high BP prior to or... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Maternal high blood pressure (BP) was associated with adverse pregnancy outcomes. This study aimed to synthesize evidence on the association between high BP prior to or in early pregnancy with maternal and fetal complications.
METHODS
We searched the cohort studies assessing the effect of high BP in the Medline, Embase, Web of Science and China National Knowledge Internet databases. A random-effects model was used to estimate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). The protocol was registered in PROSPERRO (CRD 42023414945).
RESULTS
23 eligible studies were identified. High BP prior to or in early pregnancy was associated with higher odds of hypertensive disorders of pregnancy (OR 2.90, 95% CI 1.91-3.89), gestational hypertension (2.56, 2.01-3.12), preeclampsia (3.20, 2.66-3.74), gestational diabetes mellitus (1.71, 1.36-2.06), preterm birth (1.66, 1.39-1.93), stillbirth (2.01, 1.45-2.58) and neonatal intensive care unit admission (1.22, 1.08-1.37). Subgroup analyses indicated that pre-hypertension could significantly increase the odds of these outcomes except for stillbirth, though the odds were lower than hypertension.
CONCLUSIONS
High BP prior to or in early pregnancy was associated with adverse pregnancy outcomes and this association increased with hypertension severity. The findings emphasized an urgent need for heightened surveillance for maternal BP, especially pre-hypertensive status.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Stillbirth; Premature Birth; Pregnancy Outcome; Hypertension, Pregnancy-Induced; Pre-Eclampsia
PubMed: 38151254
DOI: 10.1080/14767058.2023.2296366 -
Frontiers in Psychiatry 2024Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective...
BACKGROUND
Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective was to conduct a systematic review and meta-analysis on the influence of burnout on cardiovascular disease.
METHODS
Studies reporting risk (odds ratio, relative risk, and hazard ratio) of cardiovascular disease following burnout were searched in PubMed, PsycINFO, Cochrane, Embase, and ScienceDirect. We performed a random-effect meta-analysis stratified by type of cardiovascular disease and searched for putative influencing variables. We performed sensitivity analyses using the most adjusted models and crude risks.
RESULTS
We included 25 studies in the systematic review and 9 studies in the meta-analysis (4 cross-sectional, 4 cohort, and 1 case-control study) for a total of 26,916 participants. Burnout increased the risk of cardiovascular disease by 21% (OR = 1.21, 95% CI 1.03 to 1.39) using the most adjusted risks and by 27% (OR = 1.27, 95% CI 1.10 to 1.43) using crude risks. Using stratification by type of cardiovascular disease and the most adjusted risks, having experienced burnout significantly increased the risk of prehypertension by 85% (OR = 1.85, 95% CI 1.00 to 2.70) and cardiovascular disease-related hospitalization by 10% (OR = 1.10, 95% CI 1.02 to 1.18), whereas the risk increase for coronary heart disease (OR = 1.79, 95% CI 0.79 to 2.79) and myocardial infarction (OR = 1.78, 95% CI 0.85 to 2.71) was not significant. Results were also similar using crude odds ratio. The risk of cardiovascular disease after a burnout was not influenced by gender. Insufficient data precluded other meta-regressions.
CONCLUSIONS
Burnout seems to increase the risk of cardiovascular disease, despite the few retrieved studies and a causality weakened by cross-sectional studies. However, numerous studies focused on the pathophysiology of cardiovascular risk linked to burnout, which may help to build a preventive strategy in the workplace.
PubMed: 38439796
DOI: 10.3389/fpsyt.2024.1326745