• Title/Summary/Keyword: Hypertension and Meta-Analysis

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Baduanjin for Hypertension : Systematic Review (팔단금 도인 운동이 고혈압에 미치는 영향 : 체계적 문헌 고찰)

  • Cho, Hyung-Joon;Bae, Dong-Ryeol;Kim, Hee-Na;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.1
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    • pp.43-56
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    • 2017
  • Objectives : To determine the effectiveness of Baduanjin for hypertension Methods : We searched 8 electronic databases(Pubmed, CAJ, EMBASE, Cochrane Library, KISS, KISTI, NDSL, RISS) up to April 2017. We included randomized controlled trials(RCTs) using Badanjin for hypertension. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results : 14 RCT studies were eligible in our review. 14 studies were divided into 4 groups, and 2 of them were meta-analysised. The meta-analysis of 10 studies showed favorable results for the use of Baduanjin with Usual care than Usual care. But, meta-analysis of 2 studies showed Baduanjin and Usual care has no difference. High risk of bias were observed in all studies. Conclusions : Although there are favorable results with meta-analysis, our systematic review are highly dependent on the single source of Chinese electrical database, CAJ. Now limited evidence is available to support Baduanjin combined usual care for hypertension and further well-designed RCTs should be encouraged.

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Chuna Manual Therapy for Essential Hypertension : A Systematic Review (원발성 고혈압에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Lim, Kyeong-Tae;Hwang, Eui-Hyoung;Kim, Byung-Jun;Park, In-Hwa;Heo, In
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.1
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    • pp.29-42
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    • 2017
  • Objectives : To determine the evidence of effectiveness and safety of Chuna manual therapy(CMT) for essential hypertension Methods : We searched 11 electronic databases(Pubmed, Web of Science, EMBASE, Cochrane Library, CAJ, KISTI, KISS, NDSL, KMBASE, RISS, DBpia) and related 2 journals up to April 2017. We included randomized controlled trials(RCTs) of testing Chuna manual therapy for hypertension patients. Results : Twenty one RCTs were eligible in our inclusion criteria. The meta-analysis of eighteen studies showed positive results for the using Chuna manual therapy for essential hypertension. Conclusions : There is favorable evidence of Chuna manual therapy for treating essential hypertension with meta-analysis. However, our systematic review has limited evidence to support Chuna manual therapy for essential hypertension because of low quality of original articles and further well-designed RCTs should be encouraged.

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A Meta-Analysis on the Associations of Gly460Trp Polymorphism of the $\alpha$-Adducin Gene with Hypertension

  • Kang, Byung-Yong;Lee, Kang-Oh;Bae, Joon-Seol;Kim, Ki-Tae;Kim, Jae-Hyun;Ryu, Jae-Chun;Lee, Chung-Choo
    • Environmental Mutagens and Carcinogens
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    • v.22 no.2
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    • pp.70-75
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    • 2002
  • Gly460Trp polymorphism of a-adducin gene has been reported to be associated with hypertension in some populations, and we, therefore, attempted to replicate this finding in Korean population. There were no significant differences in allele and genotype frequencies of Gly460Trp polymorphism in Korean normotensives and hypertensives, respectively. The meta-analysis revealed that the Mantel-Haenszel estimate of the odds ratio across the studies was 1.17 (95%CI 1.04-1.31), and that there was significant evidence against homogeneity of the odds ratio among the studies included (Breslow-Day test = 27.34, df = 9, p = 0.001). Although the meta- analysis appeared in favour of association between the Gly4601tf polymorphism of $\alpha$-adducin gene and hypertension, there was the considerable heterogeneity among the studies and the evidence is also rather borderline. Further comprehensive approaches are needed to resolve this debatable issue.

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Meta-analysis of Hypertension-related Nursing Intervention Programs (고혈압 간호중재의 혈압하강 효과에 대한 메타분석)

  • So, Eun-Sun;Lee, In-Sook
    • Journal of East-West Nursing Research
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    • v.16 no.1
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    • pp.11-18
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    • 2010
  • Purpose: The aim of this study was to examine the characteristics of hypertension-related nursing intervention programs and their effects on systolic and diastolic blood pressure. Methods: Fifteen studies were selected from four databases (Korean studies, Riss4U, RICHIS, and JKAN) published as of 2009. They were analyzed by meta-analysis method. The selected studies contained a control group with pre-test and post-test design, measured blood pressure as a dependent variable, and used a reported statistical value for blood pressure to measure the size of effects. Results: The hypertension-related nursing intervention programs were relatively effective in lowering both systolic and diastolic blood pressure, although they were more efficient to decrease diastolic pressure. Among the hypertension-related intervention programs, complementary and alternative therapies were more effective in lowering blood pressure compared to lifestyle change intervention. Conclusions: To acquire substantial data of intervention effects, and complementary and alternative therapy, subjects in pre-hypertensive stage, and elderly people, better industrial and scholastic research methods need to be developed for future research. Further studies are needed to establish complementary and alternative therapies. Studies with different group of participants and studies using effective research design are in need as well.

The Meta-Analysis Study on the Risk Factors of Stroke (메타분석을 통한 중풍 위험인자 연구)

  • Yeo, Hyeon-Su;Jun, Chan-Yong;Choi, You-Kyung;Ko, Seung-Gyu;Ko, Ho-Yeon;Park, Jong-Hyeong
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.59-65
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    • 2008
  • Objective : This study was conducted to integrate the results of studies which show the relationship between risk factors(smoking, drinking, intaking coffee, exercise, BMI, family history, hypertension, DM, hyperlipidemia, heart disease, TIA) and the incidence of stroke in Korean adults. Methods : We surveyed 17 stroke-related articles, published between 1995 and 2007, and conduct meta-analysis. And we estimated common odds ratio(OR). Results : The overall OR of risk factors associated CVD were as follow : Smoking had a 2.488 OR, no regular exercise had a 1.942 OR, $BMI{\geq}25$ had a 1.848 OR, hypertension had a 6.053 OR, DM had a 2.931 OR, heart disease had a 5.455 OR, and TIA had a 5.238 OR. Conclusion : The result of this study suggest that smoking, no regular exercise, $BMI{\geq}25$, hypertension, DM, heart disease, and TIA are important risk factor of stroke.

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Influence of Clinically Significant Portal Hypertension on Hepatectomy for Hepatocellular Carcinoma: a Meta-analysis

  • Tang, Yun-Hao;Zhu, Wen-Jiang;Wen, Tian-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1649-1654
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    • 2014
  • Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.

Ginseng for Reducing the Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

  • Hur, Myung-Haeng;Lee, Myeong-Soo;Yang, Hye-Jeong;Kim, Chan;Bae, Ik-Lyul;Ernst, Edzard
    • Journal of Ginseng Research
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    • v.34 no.4
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    • pp.342-347
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    • 2010
  • Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

A Meta-analysis on the Risk Factors of Cerebrovascular Disorders in Koreans (한국인 뇌혈관질환의 위험요인에 관한 메타분석)

  • Park, Jong-Ku;Kang, Myung-Guen;Kim, Chun-Bae;Kim, Ki-Soon;Jee, Sun-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1 s.60
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    • pp.27-48
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    • 1998
  • This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholesterol were selected as subjects of quantitative meta-analysis on risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28 (95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding total serum cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.

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Effects of Panax ginseng on hyperglycemia, hypertension, and hyperlipidemia: A systematic review and meta-analysis

  • Park, Soo Hyun;Chung, Sangwon;Chung, Min-Yu;Choi, Hyo-Kyoung;Hwang, Jin-Taek;Park, Jae Ho
    • Journal of Ginseng Research
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    • v.46 no.2
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    • pp.188-205
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    • 2022
  • Panax ginseng is a medicinal plant is a material with various pharmacological activities and research suggests that it is particularly effective in representative metabolic diseases such as hyperglycemia, hypertension, and hyperlipidemia. Therefore, in this study, systematic review and meta-analysis were performed to investigate the comprehensive effect of P. ginseng on metabolic parameters representing these metabolic diseases. A total of 23 papers were collected for inclusion in the study, from which 27 datasets were collected. The investigational products included P. ginseng and Korean Red ginseng. Across the included studies, the dose ranged from 200 mg to 8 g and the supplementation period lasted from four to 24 weeks. The study subjects varied from healthy adults to those with diabetes, hypertension, obesity, and/or hyperlipidemia. As a result of the analysis, the levels of glucose and insulin area under the curves, % body fat, systolic and diastolic blood pressures, total cholesterol, triglycerides, and low-density lipoprotein cholesterol were significantly reduced in the P. ginseng group as compared with in the placebo group. In conclusion, P. ginseng supplementation may act as an adjuvant to prevent the development of metabolic diseases by improving markers related to blood glucose, blood pressure, and blood lipids.

The Effect of Cheonmagudeung-eum for Hypertension: A Systematic Review and Meta-analysis (고혈압에 대한 천마구등음의 효과 : 체계적 문헌고찰과 메타분석)

  • Kang, Ki-wan;Kang, Ja-yeon;Jeong, Min-jeong;Kim, Hong-jun;Sun, Seung-ho;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.22-43
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    • 2018
  • Objective: The purpose of this study is to investigate the effect of Cheonmagudeung-eum (CGE) for essential hypertension by systematic review and meta-analysis. Methods: The period of literature search was until October 30, 2016, and 14 electronic databases were utilized as search engines. The evaluation for the risk of bias (RoB) was conducted by using the Cochrane Risk of Bias Tool. The meta-analysis was performed by synthesizing outcome data, including total effective rate (TER), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of adverse events. Result: There were a total of 64 RCTs using CGE on adult essential hypertension. In the RoB evaluation, most of the items were unclear, and the qualities of studies were rated low. The concurrent treatment of CGE and antihypertensive drug (AHD) showed a significant hypotensive effect since the risk ratio (RR) of TER was 1.17 times (95% CI 1.14, 1.20, p<0.01) higher than that of AHD alone. In addition, the mean difference (MD) appeared low as 8.73 mm/Hg in SBP (95% CI -11.36, -6.09, p<0.01) and 5.81 mm/Hg in DBP (95% CI -7.50, -4.12, p<0.01). Conclusion: Through this study, it was identified that the combined treatment of CGE and AHD on hypertension would be more effective than that of AHD treatment alone. However, due to the low quality of the selected original articles, the significance of this conclusion is somewhat limited, and we hope that this would be complemented through more rigorous RCTs in the future.