Rosuvastatin for the prevention of venous thromboembolism: a pooled analysis of the HOPE-3 and JUPITER randomized controlled trials

2021 ◽  
Author(s):  
Philip Joseph ◽  
Robert Glynn ◽  
Eva Lonn ◽  
Chinthanie Ramasundarahettige ◽  
John Eikelboom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Randomized Controlled ◽  
History Of ◽  
Proportional Reduction ◽  
History Of Cancer

Abstract Aims To examine the association between rosuvastatin and VTE risk, and whether effects vary in different subpopulations stratified by key demographic, cardiovascular disease (CVD) risk factors and other risk factors associated with VTE. Methods and Results An individual participant data meta-analysis was conducted across two randomized controlled trials in 30,507 participants over a mean follow up of 3.62 years, Individuals had no prior history of vascular disease but were at intermediate CV risk. In both trials, participants were randomized to receive rosuvastatin or matching placebo. The primary outcome was VTE during follow-up, defined as either deep vein thrombosis or pulmonary embolism. Associations between rosuvastatin and VTE were examined in the overall pooled cohort, and subpopulations stratified by demographic risk factors (i.e. age, sex), CVD risk factors (i.e. obesity, smoking, lipid levels, blood pressure levels, C-reactive protein level), and a history of cancer. Mean age was 65.96 (SD 7.19) years of age, and 17,832 (58.45%) were male. 5,434 (17.82%) were smokers, median BMI was 27.6 (Interquartile range [IQR] 24.7 - 31.1) kg/m2, and median CRP level was 3.4 (IQR 2.1 - 6.0) mg/L. There were 139 VTE events. In the pooled cohort, rosuvastatin was associated with a large proportional reduction in the risk of VTE (hazard ratio 0.53, 95% CI 0.37 – 0.75). No significant interactions were observed between treatment with rosuvastatin and the risk of VTE across subpopulations stratified by demographic, CVD risk factors or a history of cancer (p-values for interactions >0.05 for all subgroups). Conclusions Rosuvastatin is associated with a 47% proportional reduction in the risk of VTE, and its effect is consistent both in the presence or absence of VTE related clinical risk factors Translational Perspective In this individual participant data meta-analysis of two large randomized controlled trials comparing rosuvastatin to placebo, rosuvastatin was associated with a 47% proportional reduction in the risk of VTE. The effect of rosuvastatin was consistent across a broad range of demographic factors, cardiovascular risk factors, and a history of cancer. This study demonstrates that rosuvastatin is broadly affective at reducing the risk of VTE both in the presence or absence of VTE associated clinical risk factors. Results inform future research on the use of statins for this indication.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

Incorporating healthy dietary changes in addition to an increase in fruit and vegetable intake further improves the status of cardiovascular disease risk factors: A systematic review, meta-regression, and meta-analysis of randomized controlled trials

2019 ◽  
Vol 78 (7) ◽  
pp. 532-545 ◽  
Author(s):  
Darel Wee Kiat Toh ◽  
Evangelyn Sihui Koh ◽  
Jung Eun Kim
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Dietary Changes ◽  
Randomized Controlled ◽  
Meta Regression

Abstract Context Fruit and vegetable (FV) intake has been associated with a reduced risk of cardiovascular disease (CVD). Beyond increasing FV intake, the incorporation of other healthy dietary changes may help to further attenuate CVD risk. Objective A systematic review and meta-analysis was conducted to determine the effect of increasing FV intake to > 3 servings daily as well as incorporating other healthy dietary changes on classical CVD risk factors through a systematic review, meta-regression, and meta-analysis of randomized controlled trials. Data Sources The following databases were searched: PubMed, CINAHL Plus with Full Text, Medline (ProQuest), and Cochrane Library. Data Extraction 82, 24, and 10 articles were selected for the systematic review, meta-regression, and meta-analysis, respectively. Data Analysis Meta-regression analysis showed a dose-dependent response between the number of FV servings consumed in each intervention group and the blood triglyceride change value. Pooled weighted mean differences from the meta-analysis suggested that increasing FV intake to > 3 servings daily contributes to significant decreases in triglyceride (−0.10 mmol/L; 95%CI, −0.18 to −0.01) and diastolic blood pressure (−1.99 mmHg; 95%CI, −2.28 to −1.70) as well as marginal decreases in total cholesterol and low-density lipoprotein cholesterol. While improvements were observed in the triglyceride and high-density lipoprotein cholesterol response following the incorporation of other healthy dietary changes, no additional cardiovascular benefits were observed when FV intake was increased from > 3 to > 5 servings daily. Conclusion Increasing FV intake to > 3 servings daily improves CVD risk factors, most distinctly triglyceride, especially when complemented with other healthy dietary changes.

Association between berries intake and cardiovascular diseases risk factors: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials

2018 ◽  
Vol 9 (2) ◽  
pp. 740-757 ◽  
Author(s):  
Ângelo Luís ◽  
Fernanda Domingues ◽  
Luísa Pereira
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Randomized Controlled

The main goal of this work was to clarify the effects of the consumption of berries on cardiovascular disease (CVD) risk factors by performing a systematic review followed by a meta-analysis and a trial sequential analysis (TSA).

Exercise and Cardiovascular Disease Risk Factors in Children and Adolescents With Obesity: A Systematic Review With Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 155982762098883
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley ◽  
Russell R. Pate
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Strength Training ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Strength Of Evidence ◽  
Randomized Controlled

The purpose of this study was to examine the effects of exercise on cardiovascular disease (CVD) risk factors in children and adolescents with obesity. Randomized controlled trials (RCTs) of exercise ≥4 weeks in children and adolescents with obesity were included if one or more CVD risk factors were included as an outcome. Studies were retrieved by searching 7 electronic databases, cross-referencing, and expert review. Data were pooled using the inverse-variance heterogeneity (IVhet) model and strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Thirty-nine studies representing 1548 participants (847 exercise, 701 control) met the inclusion criteria. Aerobic exercise improved 10 of 12 (83.3%) outcomes ( P < .05 for all) while combined aerobic and strength training improved 5 of 8 (62.5%) outcomes ( P < .05 for all). The strength of evidence ranged from “very low” to “moderate.” It was concluded that aerobic exercise, as well as combined aerobic and strength training, is associated with improvements in multiple CVD risk factors among children and adolescents with obesity. However, the generally low strength of evidence suggests a need for future well-designed and conducted RCTs on the effects of exercise, especially strength training, in children and adolescents with obesity.

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