scholarly journals Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studies and 18,300 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angelo Silverio ◽  
Marco Di Maio ◽  
Rodolfo Citro ◽  
Luca Esposito ◽  
Giuseppe Iuliano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cardiovascular Risk ◽  
Hospital Mortality ◽  
Cardiovascular Risk Factors ◽  
Meta Analysis ◽  
Hospital Death ◽  
Male Sex ◽  
Meta Regression ◽  
Meta Regression Analysis

Abstract Background A high prevalence of cardiovascular risk factors including age, male sex, hypertension, diabetes, and tobacco use, has been reported in patients with Coronavirus disease 2019 (COVID-19) who experienced adverse outcome. The aim of this study was to investigate the relationship between cardiovascular risk factors and in-hospital mortality in patients with COVID-19. Methods MEDLINE, Cochrane, Web of Sciences, and SCOPUS were searched for retrospective or prospective observational studies reporting data on cardiovascular risk factors and in-hospital mortality in patients with COVID-19. Univariable and multivariable age-adjusted analyses were conducted to evaluate the association between cardiovascular risk factors and the occurrence of in-hospital death. Results The analysis included 45 studies enrolling 18,300 patients. The pooled estimate of in-hospital mortality was 12% (95% CI 9–15%). The univariable meta-regression analysis showed a significant association between age (coefficient: 1.06; 95% CI 1.04–1.09; p < 0.001), diabetes (coefficient: 1.04; 95% CI 1.02–1.07; p < 0.001) and hypertension (coefficient: 1.01; 95% CI 1.01–1.03; p = 0.013) with in-hospital death. Male sex and smoking did not significantly affect mortality. At multivariable age-adjusted meta-regression analysis, diabetes was significantly associated with in-hospital mortality (coefficient: 1.02; 95% CI 1.01–1.05; p = 0.043); conversely, hypertension was no longer significant after adjustment for age (coefficient: 1.00; 95% CI 0.99–1.01; p = 0.820). A significant association between age and in-hospital mortality was confirmed in all multivariable models. Conclusions This meta-analysis suggests that older age and diabetes are associated with higher risk of in-hospital mortality in patients infected by SARS-CoV-2. Conversely, male sex, hypertension, and smoking did not independently correlate with fatal outcome.

Rate of Death and Complications in Laparoscopic and Open Roux-en-Y Gastric Bypass. A Meta-analysis and Meta-regression Analysis on 69,494 Patients

2016 ◽  
Vol 26 (8) ◽  
pp. 1956-1963 ◽  
Author(s):  
Emanuele Rausa ◽  
Luigi Bonavina ◽  
Emanuele Asti ◽  
Maddalena Gaeta ◽  
Cristian Ricci
Keyword(s):  
Gastric Bypass ◽  
Regression Analysis ◽  
Meta Analysis ◽  
Meta Regression ◽  
Meta Regression Analysis

scholarly journals Effect Modification by Age on the Benefit or Harm of Antihypertensive Treatment for Elderly Hypertensives: A Systematic Review and Meta-analysis

2018 ◽  
Vol 32 (2) ◽  
pp. 163-174 ◽  
Author(s):  
Chi-Jung Huang ◽  
Chern-En Chiang ◽  
Bryan Williams ◽  
Kazuomi Kario ◽  
Shih-Hsien Sung ◽  
...  
Keyword(s):  
Renal Failure ◽  
Regression Analysis ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Effect Modification ◽  
Close Monitoring ◽  
Increased Risk ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Elderly Hypertensives

Abstract BACKGROUND The influence of age on balance of benefit vs. potential harm of blood pressure (BP)-lowering therapy for elderly hypertensives is unclear. We evaluated the modifying effects of age on BP lowering for various adverse outcomes in hypertensive patients older than 60 years without specified comorbidities. METHODS All relevant randomized controlled trials (RCTs) were systematically identified. Coronary heart disease, stroke, heart failure (HF), cardiovascular death, major adverse cardiovascular events (MACE), renal failure (RF), and all-cause death were assessed. Meta-regression analysis was used to explore the relationship between achieved systolic BP (SBP) and the risk of adverse events. Random-effects meta-analysis was used to pool the estimates. RESULTS Our study included 18 RCTs (n = 53,993). Meta-regression analysis showed a lower achieved SBP related with a lower risk of stroke and cardiovascular death, but an increased risk of RF. The regression slopes were comparable between populations stratifying by age 75 years. In subgroup analysis, the relative risks of a more aggressive BP lowering strategy were similar between patients aged older or less than 75 years for all outcomes except for RF (P for interaction = 0.02). Compared to treatment with final achieved SBP 140–150 mm Hg, a lower achieved SBP (&lt;140 mm Hg) was significantly associated with decreased risk of stroke (relative risk = 0.68; 95% confidence interval = 0.55–0.85), HF (0.77; 0.60–0.99), cardiovascular death (0.68; 0.52–0.89), and MACE (0.83; 0.69–0.99). CONCLUSIONS To treat hypertension in the elderly, age had trivial effect modification on most outcomes, except for renal failure. Close monitoring of renal function may be warranted in the management of elderly hypertension.

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