• 제목/요약/키워드: Hypertension and Meta-Analysis

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본태성 고혈압에 대한 기국지황환(杞菊地黄丸)의 효과에 관한 체계적 고찰 및 메타 분석 (Qu-Ji-Du-Huang-Wan for Essential Hypertension : Systemic Review and Meta-analysis)

  • 한인식;신지혜;조윤영;박해모;양창섭;정민정;장인수;선승호
    • 동의생리병리학회지
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    • 제31권2호
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    • pp.118-125
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    • 2017
  • The purpose of this study is to investigate the blood pressure reducing effect of Qi-Ju-Di-Huang-Wan (QJDHW) in adults with essential hypertension by using methods of systemic review and meta-analysis. Major search engines, such as PubMed, EMBASE, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, KISS, NDSL, RISS, OASIS, DBpia and so on, were used. The search period we used is from the start date of the search engine to October 30, 2016 and no language limits were placed. Randomized controlled trials using QJDHW in adults with essential hypertension were searched and extracted by two independent researchers. Meta-analysis was performed on outcome variables of the total effective rate (TER), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Risk of bias (RoB) of Cochrane was used to assess methodological quality. Thirteen studies were finally selected. We observed that the combined treatment of QJDHW and antihypertensive drug had 3.6 times the odds ratio of TER for blood pressure lowering than a single use of an antihypertensive drug. Additionally, mean differences of SBP and DBP were -8.88 mmHg (95% Confidential Interval (CI) -12.77 mmHg, -5.00 mmHg, P<0.00001), -7.09 mmHg (95% CI -9.93, -4.25, P <0.00001), respectively. Single use of QJDHW did not reduce blood pressure more than an antihypertensive drug. All items of RoB were unclear and the methodological quality was low. Our analysis suggests that the combination of QJDHW and antihypertensive drugs may be more effective in reducing blood pressure than a single antihypertensive drug. But due to low methodological quality, careful interpretation will be needed and systematic long-term clinical trials will be required.

혈부축어탕의 본태성 고혈압에 대한 치료 효과 관한 메타 분석 및 체계적 고찰 (Xuefuzhuyu Decoction for Essential Hypertension: Meta-Analysis and Systemic Review)

  • 한인식;장인수;선승호
    • 대한한방내과학회지
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    • 제39권6호
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    • pp.1150-1167
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    • 2018
  • Objective: The purpose of this study was to investigate the effect reducing blood pressure (BP) using Xuefuzhuyu Decoction (XFZYD) in adults with essential hypertension (EH). Method: Search engine, such as PubMed, EMBASE, Cochrane library, Web of Science, J-STAGE, CiNii, CNKI, OASIS, NDSL, KISS, RISS, and DBpia, were used. The search period was from the beginning of the search engine to June 30, 2018 and there were no limits regarding languages. The selection and extraction of literatures were performed independently by two authors. Meta-analysis was done on the total effective rate (TER), Systolic BP (SBP) and Diastolic BP (DBP). Cochrane's risk of bias (ROB) was used as the methodological quality assessment scale. Results: Twenty studies were finally selected. We observed that a combination treatment using XFZYD and an antihypertensive drug (AHD) was 5.1 times more effective in lowering BP than using AHD alone on TER. The mean differences in SBP and DBP were -10.65 mmHg (95% Confidential Interval (CI) -13.55 mmHg, -7.74 mmHg, P<0.00001), -5.92 mmHg (95% CI -7.14, -4.38, P<0.00001), respectively. Conclusion: A combination treatment using XFZYD and AHD may be more effective in reducing BP than using AHD alone. Because of the poor methodological quality of the studies conducted thus far, high-quality clinical trials will be required in the future.

기공 운동 치료가 고혈압에 미치는 영향: 체계적 문헌 고찰 (Qigong Exercise Therapy for Hypertension: A Systematic Review)

  • 안재규;이상현;김현태;박선영;허인;정민정;황의형;장인수
    • 척추신경추나의학회지
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    • 제15권2호
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    • pp.9-18
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    • 2020
  • Objectives This study verified the clinical effectiveness of Qigong exercise therapy for individuals with hypertension. Methods Ten electronic databases were used for information retrieval. Only randomized controlled trials (RCTs) using Qigong exercise therapy as a treatment for hypertension were included in this study. Cochrane risk of bias tool was used to assess the methodological quality of each RCT. Results After a thorough review, six RCTs were deemed eligible. These studies were divided into two groups: Qigong vs. no intervention and Qigong plus anti-hypertensive drug vs. anti-hypertensive drug alone. Among the six RCTs, four studies were Qigong vs. no intervention, and two studies were Qigong plus anti-hypertensive drug vs. anti-hypertensive drug alone. The meta-analysis demonstrated that adding Qigong exercise to anti-hypertensive drug treatment lowers diastolic blood pressure more than the anti-hypertensive drug alone. Conclusions Although Qigong exercise is not widely used in the Korean medical field, the results of this study demonstrated the necessity of exercise while controlling hypertension. However, the number of included studies was small, with their high risk of bias. In conclusion, although it is difficult to determine whether Qigong exercise lowers blood pressure in hypertensive patients, exercise including Qigong must be parallel with the intake of anti-hypertensive drugs.

고혈압에 대한 한약 이수 처방 효과에 대한 체계적 문헌 고찰 및 메타분석 (The Effect of Korean Herbal Medicine that Function by Inducing Diuresis for Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials)

  • 강자연;강기완;정민정;김홍준;장인수
    • 대한한방내과학회지
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    • 제38권6호
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    • pp.902-916
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    • 2017
  • Objectives: The aim of this study was to review the clinical research on antihypertensive effects of Korean herbal medicines that function by inducing diuresis. Methods: Literature searches were performed using PubMed, Cochrane, CNKI, Wanfang, Cinii, Oasis, KISS, NDSL, RISS, DBPia, with the keywords "利水", "利尿", "高血壓", "hypertension", and "lishui." The search range included only randomized controlled trials that verified the effects of Korean herbal medicine interventions on hypertension. The selected studies were assessed by risk of bias (RoB). Results: 26 reports were selected from a total of 532 identified. For these reports, meta-analysis was performed using Revman 5.3. From this analysis, it was observed that the combined treatment of Korean medicine and antihypertensive drugs had a significantly higher total effective rate (TER) and improvement in systolic blood pressure (SBP) and diastolic blood pressure (DBP) than did the use of a single antihypertensive drug. The risk ratio of TER for lowering blood pressure was 1.25. The mean differences of SBP, DBP were -19.63 mm Hg (95% confidential interval (CI), -22.45 mm Hg, -16.80 mm Hg, p<0.00001), and -5.39 mm Hg (95% CI, -7.36 mm Hg, -3.42 mm Hg, p<0.00001) respectively. The use of Korean medicine only did not improve blood pressure, as compared to the use of an antihypertensive drug. Most of items of RoB were unclear, and the methodological quality was low. Conclusions: The combination of antihypertensive drugs and Korean medical treatment can effectively improve SBP, DBP, and TER. This finding could be widely utilized in clinical practice in Korean medicine.

유산소 운동이 고혈압 환자의 혈중지질, 체중 및 체질량지수에 미치는 효과: 체계적 문헌고찰 및 메타분석 (Effect of Aerobic Exercise on Serum Lipids, Weight and Body Mass Index in Patients with Hypertension: A Systematic Review and Meta-analysis)

  • 채영란;이선희
    • Journal of Korean Biological Nursing Science
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    • 제22권1호
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    • pp.11-22
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect of aerobic exercise on serum lipids, body weight, and body mass index in adults with hypertension using a systematic review and meta-analysis. Methods: Six electronic databases (PubMed, EMBASE, Co-chrane library, CINAHL, PsycINFO, SPORTDiscus) and five domestic databases were searched for randomized controlled trials studies. We used random effect models to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on serum lipids, body weight, and body mass index. Results: Nineteen studies met our inclusion criteria. In comparison with the control group, triglyceride level (TG) (-13.49 mg/dL, 95% CI: -26.74 to -0.24) and body weight (-0.62 kg, 95% CI: -1.08 to -0.16) difference between follow-up and baseline was significantly reduced in the aerobic exercise group. However, no difference was found in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI). Conclusion: Aerobic exercise is effective in reducing the TG level and body weight in adults with hypertension. In order to improve levels of serum TC, LDL-C and HDL-C of hypertensive patients, it's needed to combine other intervention methods such as diet therapy.

Understanding the genetics of systemic lupus erythematosus using Bayesian statistics and gene network analysis

  • Nam, Seoung Wan;Lee, Kwang Seob;Yang, Jae Won;Ko, Younhee;Eisenhut, Michael;Lee, Keum Hwa;Shin, Jae Il;Kronbichler, Andreas
    • Clinical and Experimental Pediatrics
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    • 제64권5호
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    • pp.208-222
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    • 2021
  • The publication of genetic epidemiology meta-analyses has increased rapidly, but it has been suggested that many of the statistically significant results are false positive. In addition, most such meta-analyses have been redundant, duplicate, and erroneous, leading to research waste. In addition, since most claimed candidate gene associations were false-positives, correctly interpreting the published results is important. In this review, we emphasize the importance of interpreting the results of genetic epidemiology meta-analyses using Bayesian statistics and gene network analysis, which could be applied in other diseases.

Meta-analysis of the Efficacy of Sorafenib for Hepatocellular Carcinoma

  • Wang, Zhao;Wu, Xiao-Ling;Zeng, Wei-Zheng;Xu, Gui-Sen;Xu, Hui;Weng, Min;Hou, Juan-Ni;Jiang, Ming-De
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.691-694
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    • 2013
  • Purpose: By carrying out a meta-analysis of randomized controlled trials that compared sorafenib or combined chemotherapy with placebo or combined chemotherapy, the effectiveness of sorafenib in hepatocellular carcinoma was evaluated in the present study, which also provided clinical practice guidelines of evidence-based-medicine. Methods: We reviewed PubMed citations concerning sorafenib treating hepatocellular carcinoma in randomized controlled trials from Jan 2000 to July 2012. All the literature was extracted by Cochrane systematic reviews and underwent meta-analysis with RewMan 5.0 software. Results: Finally, four papers documenting randomized controlled studies were included. Compared with controls, sorafenib was shown to significantly increase overall survival (OS), time to progression (TTP), and disease control rates (DCR), but not the time to symptom progression (TTSP) in hepatocellular carcinoma patients. The incidence of grade-III/IV adverse reactions, including hand-foot-skin reactions, diarrhea, hypertension and skin rash or desquamation, in sorafenib treatment group was higher than that in controls. However, there was no significant difference in the incidence of hypodynamia between the two groups. Conclusions: Sorafenib exerts significant curative effects in hepatocellular carcinoma.

Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis

  • Lee, Sun Hee;Chae, Young Ran
    • 대한간호학회지
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    • 제50권6호
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    • pp.740-756
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. Methods: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. Results: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. Conclusion: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

SNP Analysis of the Human LDL Receptor and CETP Gene in Korean Subjects with Hypertension

  • Shin, Jae-Hyun;Kang, Byung-Yong;Lee, Kang-Oh;Eo, Hyun-Shun;Bae, Joon-Seol;Kim, Ki-Tae;Kim, Hyun-Sup;Lee, Chung-Choo
    • 한국환경성돌연변이발암원학회지
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    • 제22권1호
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    • pp.47-53
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    • 2002
  • Essential hypertension is complex disorder influenced by multiple genetic and environmental factors. Alterations of lipid metabolism in plasma have been reported to be related to an increased risk of essential hypertension. The aim of this study was to investigate the relationship between two SNPs of the human LDL receptor and CETP gene and hypertension in Korean population. There were no significant differences in allele and genotype frequencies of two SNPs in normotensives and hypertensives. With respect to Hinc II RFLP in the LDL receptor gene, pooled odds ratio value indicated the significant heterogeneity among populations studied by meta-analysis (Breslow-Day test df = 2, P<0.05). In the case of Bam HI RFLP in the CETP gene,. our study is the first report of an association between the SNP of the CETP gene and hypertension, although our result failed to demonstrate the significant association between the Bam HI RFLP of the CETP gene and hypertension in Korean population. Further work, using larger sample sizes and various ethnic groups, is required to establish the precise role of these two candidate gene polymorphisms on hypertension.

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류마티스질환 환자의 인지손상과 관련된 요인 규명: 체계적 문헌고찰 및 메타분석 (Correlates of Cognitive Impairment of Rheumatic Disease: Systematic Review and Meta-analysis)

  • 모진아;박지숙;오현수
    • 대한간호학회지
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    • 제46권1호
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    • pp.1-18
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    • 2016
  • Purpose: This study was conducted to synthesis the results of research on relationships of cognitive impairment with multi-dimensional correlates of rheumatic disease through a systematic literature review and meta-analysis. Methods: For the study purpose, 23 studies were selected through a systematic process of searching the literature. Results: The study results showed that among general characteristics, age and education were the variables having a significant relationship with cognitive impairment. Among health risk factors, obesity appeared to have a significant positive relationship with cognitive impairment. For past history, diabetes and hypertension were shown to have a significant positive relationship with cognitive impairment. It was noted also that aPL, one of the physiological factor, had significant association with cognitive impairment. None of the medication related factors had a significant relationship with cognitive impairment. Results showed that among disease related factors, disease activity had the highest relationship with cognitive impairment. Depression, among psychological factors, was the only variable having a significant relationship with cognitive impairment. Conclusion: The findings indicate that the variables strongly impacting on cognitive impairment in rheumatic disease are depression and disease activity.