Does chronotherapy for essential hypertension matter by class? A systematic review and meta-analysis

Objectives The study was performed to evaluate the efficacy and safety of chronotherapy of hypertension with different medications monotherapy or a combination compared with traditional regimens Methods Three databases including PubMed, EMBASE and the Cochrane Library were searched, from the inception of each database to 10 April 2020. The Review Manager 5.4 was adopted for meta-analyses and subgroup analyses. The blood pressure delta (Δ) was used as mean of differences (MD) with 95% confidence intervals (CIs), and the estimated effect for events estimates the 95% CIs for frequency of events. The adults with essential hypertension were treated with chronotherapy and traditional regimens. Results Twenty-eight RCTs, recruiting 1865 patients in bedtime/evening dosing and 1867 in awakening/morning dosing, were enrolled in this quantitative review. Meta-analysis showed no significant differences for overall drug-related AEs (RR=0.81, P=0.17; I2=41%), but an obvious reduction of risk for overall withdrawals (RR=0.52, P=0.005; I2=0.0%) with bedtime dosing. No statistically significant differences were noted for clinic BP and diurnal BP, but 24-hour (48-hour) BP, nocturnal BP, morning BP, and non-dippers (%) showed obvious reductions, statistically. By class, there existed different efficacy between 2 administrations, with great decrease in nocturnal BP control and changes in circadian rhythm with RAAS blockers monotherapy, but an all-day control of BP for CCBs and diuretics. With regard to a combination, no significant differences in BP management were detected and the data about beta-receptor blockers were limited. Conclusions The safety and efficacy of chronotherapy in antihypertensive drugs might be based on the classes.

Is Yangxue Qingnao Granule Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, More Effective Than Antihypertensive Therapy Alone in Treating Essential Hypertension?

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/540613 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 15

Author(s):

Jie Wang ◽

Xiaochen Yang ◽

Bo Feng ◽

Weidong Qian ◽

Zhuyuan Fang ◽

...

Keyword(s):

Essential Hypertension ◽

Integrative Medicine ◽

Antihypertensive Drugs ◽

Meta Analysis ◽

Scientific Journal ◽

Potential Effect ◽

Biomedical Literature ◽

Cochrane Library ◽

Knowledge Infrastructure ◽

Background. Yangxue Qingnao granule (YQG) combined with antihypertensive drugs, a new integrative medicine therapy, has been widely used for essential hypertension (EH) in China. This study aims to assess the current clinical evidence of YQG combined with antihypertensive drugs for EH.Methods. Randomized controlled trials(RCTs) published between 1996 and 2012 on YQG combined with antihypertensive drugs versus antihypertensive drugs in treating EH were retrieved from six major electronic databases, including The Cochrane Library, PubMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Data. Meta-analysis was performed on the overall effects on blood pressure.Results. Twelve randomized trials were included. Methodological quality of the trials was evaluated as generally low. Meta-analysis showed that YQG combined with antihypertensive drugs demonstrated potential effect for lowing either SBP (MD: −7.31 [−11.75, −2.87];P=0.001) or DBP (MD: −5.21 [−8.19, −2.24];P=0.0006) compared to antihypertensive drugs alone.Conclusions. It indicated that YQG combined with antihypertensive drugs is more effective than antihypertensive drugs alone in treating EH. However, more RCTs of larger scale, multicentre/country, longer follow-up periods, and higher quality are required to verify the efficacy of integrative medicine therapy over all antihypertensive therapies.

Influence of CYP2C9 Genetic Polymorphisms on the Pharmacokinetics of Losartan and Its Active Metabolite E-3174: A Systematic Review and Meta-Analysis

Journal of Personalized Medicine ◽

10.3390/jpm11070617 ◽

2021 ◽

Vol 11 (7) ◽

pp. 617

Author(s):

Yoon-A Park ◽

Yu-bin Song ◽

Jeong Yee ◽

Ha-Young Yoon ◽

Hye-Sun Gwak

Keyword(s):

Systematic Review ◽

Genetic Polymorphisms ◽

Active Metabolite ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Lower Maximum ◽

Meta Analyses ◽

The Cochrane Library ◽

This study aimed to investigate the influence of CYP2C9 genetic polymorphisms on the pharmacokinetics of losartan and its active metabolite, E-3174, through a systematic review and meta-analysis. Eight studies published before March 2021 were included in this study. We used PubMed, the Cochrane Library, EMBASE, and Web of Science, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The data analysis was conducted through Review Manager (RevMan), version 5.3, and R software. We found that healthy volunteers with CYP2C9*2 or *3 carriers had higher area under the curve (AUC0-∞) of losartan (mean difference (MD) 0.17 μg·h/mL; 95% confidence intervals (CI): 0.04, 0.29) and lower AUC0-∞ of E-3174 (MD −0.35 μg·h/mL; 95% CI: −0.62, −0.08) than those with CYP2C9*1/*1. Subjects with CYP2C9*2 or *3 carriers showed lower maximum concentration (Cmax) of E-3174 than those with CYP2C9*1/*1 (MD −0.13 μg/mL; 95% CI: −0.17, −0.09). For half-life, subjects with CYP2C9*2 or *3 carriers had longer half-lives of losartan and E-3174 than those with CYP2C9*1/*1 (MD 0.47 h; 95% CI: 0.32, 0.61 and MD 0.68 h; 95% CI: 0.44, 0.92, respectively). This meta-analysis suggests that the pharmacokinetics of losartan and E-3174 are associated with the CYP2C9 polymorphisms

Association Between MTHFR Polymorphisms and the Risk of Essential Hypertension: An Updated Meta-analysis

Frontiers in Genetics ◽

10.3389/fgene.2021.698590 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hao Meng ◽

Shaoyan Huang ◽

Yali Yang ◽

Xiaofeng He ◽

Liping Fei ◽

...

Keyword(s):

Sensitivity Analysis ◽

Essential Hypertension ◽

Methylenetetrahydrofolate Reductase ◽

Meta Analysis ◽

Mthfr C677t ◽

Cochrane Library ◽

Mthfr Polymorphisms ◽

Southeast Asians ◽

Increased Risk ◽

Meta Analyses

Background: Since the 1990s, there have been a lot of research on single-nucleotide polymorphism (SNP) and different diseases, including many studies on 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphism and essential hypertension (EH). Nevertheless, their conclusions were controversial. So far, six previous meta-analyses discussed the internal relationship between the MTHFR polymorphism and EH, respectively. However, they did not evaluate the credibility of the positive associations. To build on previous meta-analyses, we updated the literature by including previously included papers as well as nine new articles, improved the inclusion criteria by also considering the quality of the papers, and applied new statistical techniques to assess the observed associations. Objectives: This study aims to explore the degree of risk correlation between two MTHFR polymorphisms and EH. Methods: PubMed, EMBASE, the Cochrane Library, CNKI, and Wan Fang electronic databases were searched to identify relevant studies. We evaluated the relation between the MTHFR C677T (rs1801133) and A1298C (rs1801131) polymorphisms and EH by calculating the odds ratios (OR) as well as 95% confidence intervals (CI). Here we used subgroup analysis, sensitivity analysis, cumulative meta-analysis, assessment of publication bias, meta-regression meta, False-positive report probability (FPRP), Bayesian false discovery probability (BFDP), and Venice criterion. Results: Overall, harboring the variant of MTHFR C677T was associated with an increased risk of EH in the overall populations, East Asians, Southeast Asians, South Asians, Caucasians/Europeans, and Africans. After the sensitivity analysis, positive results were found only in the overall population (TT vs. CC: OR = 1.14, 95% CI: 1.00–1.30, Ph = 0.032, I2 = 39.8%; TT + TC vs. CC: OR = 1.15, 95% CI: 1.01–1.29, Ph = 0.040, I2 = 38.1%; T vs. C: OR = 1.14, 95% CI: 1.04–1.25, Ph = 0.005, I2 = 50.2%) and Asian population (TC vs. CC: OR = 1.14, 95% CI: 1.01–1.28, Ph = 0.265, I2 = 16.8%; TT + TC vs. CC: OR = 1.17, 95% CI: 1.04–1.30, Ph = 0.105, I2 = 32.9%; T vs. C: OR = 1.10, 95% CI: 1.02–1.19, Ph = 0.018, I2 = 48.6%). However, after further statistical assessment by FPRP, BFDP, and Venice criteria, the positive associations reported here could be deemed to be false-positives and present only weak evidence for a causal relationship. In addition, when we performed pooled analysis and sensitivity analysis on MTHFR A1298C; all the results were negative. Conclusion: The positive relationships between MTHFR C677T and A1298C polymorphisms with the susceptibility to present with hypertension were not robust enough to withstand statistical interrogation by FPRP, BFDP, and Venice criteria. Therefore, these SNPs are probably not important in EH etiology.

Influence of NQO1 Polymorphisms on Warfarin Maintenance Dose: A Systematic Review and Meta-Analysis (rs1800566 and rs10517)

Cardiovascular Therapeutics ◽

10.1155/2021/5534946 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Lihong Tian ◽

Pingping Xiao ◽

Bingrong Zhou ◽

Yishan Chen ◽

Lijuan Kang ◽

...

Keyword(s):

Maintenance Dose ◽

Meta Analysis ◽

Warfarin Dose ◽

Maintenance Dosage ◽

Sensitivity Analyses ◽

Cochrane Library ◽

The Cochrane Library ◽

The Relationship ◽

Review Manager ◽

Warfarin Maintenance Dose

This meta-analysis was conducted to analyze the effect of NQO1 polymorphism on the warfarin maintenance dosage. Using strict inclusion and exclusion criteria, we searched PubMed, EMBASE, and the Cochrane Library for eligible studies published prior to July 7, 2021. The required data were extracted, and experts were consulted when necessary. Review Manager Version 5.4 software was used to analyze the relationship between NQO1 polymorphisms and the warfarin maintenance dosage. Four articles involving 757 patients were included in the meta-analysis. Patients who were NQO1 rs10517 G carriers (AG carriers or GG carriers) required a 48% higher warfarin maintenance dose than those who were AA carriers. Patients with NQO1 rs1800566 CT carriers required a 13% higher warfarin dose than those who were CC carriers, with no associations observed with the other comparisons of the NQO1 rs1800566 genotypes. However, the results obtained by comparing the NQO1 rs1800566 genotypes require confirmation, as significant changes in the results were found in sensitivity analyses. Our meta-analysis suggests that the NQO1 rs10517and NQO1 rs1800566 variant statuses affect the required warfarin maintenance dose.

“Smoking paradox” is not true in patients with ischemic stroke: a systematic review and meta-analysis

Journal of Neurology ◽

10.1007/s00415-019-09596-3 ◽

2019 ◽

Author(s):

Bo Li ◽

Dan Li ◽

Jing-Feng Liu ◽

Lin Wang ◽

Bao-Zhu Li ◽

...

Keyword(s):

Ischemic Stroke ◽

Protective Factor ◽

Meta Analysis ◽

Vascular Diseases ◽

Cochrane Library ◽

Inverse Variance ◽

First Onset ◽

Prognostic Outcome ◽

Meta Analyses ◽

Abstract Background Ischemic stroke (IS) is a common cause of death from vascular diseases. Studies have found that smoking increases the risk of ischemic stroke, but the association of smoking with the outcome of IS remains unclear. This meta-analysis aims to investigate the effect of smoking on the prognosis of IS. Methods We searched four electronic databases including PubMed, EMBASE, Cochrane library and Web of science for papers, published before January 2019. In this meta-analysis, Review Manager 5.3 software was used to calculate for the pooled estimate effect, as well as the inverse-variance method for pooled mean difference (MD) and odds ratio (OR) of incidence in two groups of population. Results A total of 14,789 citations were identified during the literature search, 21 studies were included in the meta-analyses after screening. The full-adjusted OR of poor prognostic outcome in smoking and nonsmoking patients with stroke was pooled as 0.96 (95% CI 0.77–1.21), suggested that smoking or not has no impact on prognosis of IS. The pooled MD of onset age between smoking and nonsmoking IS patients was − 10.05 (− 12.91, − 7.19), indicated that smoking causes first onset of IS to occur 10 years earlier. Conclusions This meta-analysis showed that smoking was not a protective factor for poor prognosis of IS. Smoking patients with IS are 10 years younger than nonsmoking patients at time of the first onset of stroke.

The Effectiveness and Safety of Manual Acupuncture Therapy in Patients with Poststroke Cognitive Impairment: A Meta-analysis

Neural Plasticity ◽

10.1155/2020/8890521 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15

Author(s):

Wei Liu ◽

Chang Rao ◽

Yuzheng Du ◽

Lili Zhang ◽

Jipeng Yang

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Barthel Index ◽

Daily Life ◽

Meta Analysis ◽

Cochrane Library ◽

Activities Of Daily Life ◽

Rigorous Study ◽

Meta Analyses ◽

Background. Poststroke cognitive impairment (PSCI) is a common cause of disability among patients with stroke. Meanwhile, acupuncture has increasingly been used to improve motor and cognitive function for stroke patients. The aim of the present study was to summarize and evaluate the evidence on the effectiveness of acupuncture in treating PSCI. Methods. Eight databases (PubMed, The Cochrane Library, CNKI, WanFang Data, VIP, CBM, Medline, Embase databases) were searched from January 2010 to January 2020. Meta-analyses were conducted for the eligible randomized controlled trials (RCTs). Assessments were performed using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Barthel Index (BI), or modified Barthel Index (MBI). Results. A total of 657 relevant RCTs were identified, and 22 RCTs with 1856 patients were eventually included. Meta-analysis showed that acupuncture appeared to be effective for improving cognitive function as assessed by MMSE ( mean difference MD = 1.73 , 95% confidence interval (CI) (1.39, 2.06), P < 0.00001 ) and MoCA ( MD = 2.32 , 95% CI (1.92, 2.73), P < 0.00001 ). Furthermore, it also suggested that acupuncture could improve the activities of daily life (ADL) for PSCI patients as assessed by BI or MBI ( SMD = 0.97 , 95% CI (0.57, 1.38), P < 0.00001 ). Conclusions. Compared with nonacupuncture group, acupuncture group showed better effects in improving the scores of MMSE, MoCA, BI, and MBI. This meta-analysis provided positive evidence that acupuncture may be effective in improving cognitive function and activities of daily life for PSCI patients. Meanwhile, long retention time of acupuncture may improve cognitive function and activities of daily life, and twist technique may be an important factor that could influence cognitive function. However, further studies using large samples and a rigorous study design are needed to confirm the role of acupuncture in the treatment of PSCI.

Influence ofDPYDGenetic Polymorphisms on 5-Fluorouracil Toxicities in Patients with Colorectal Cancer: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2014/827989 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 9

Author(s):

Qiang Li ◽

Ying Liu ◽

Hong-Mei Zhang ◽

Yin-Peng Huang ◽

Tian-Yi Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Genetic Polymorphisms ◽

Web Of Science ◽

Meta Analysis ◽

Dihydropyrimidine Dehydrogenase ◽

Cochrane Library ◽

Inclusion Criteria ◽

Meta Analyses ◽

The Cochrane Library ◽

Stratified Analysis

Our meta-analysis aggregated existing results from relevant studies to comprehensively investigate the correlations between genetic polymorphisms in dihydropyrimidine dehydrogenase (DPYD) gene and 5-fluorouracil (5-FU) toxicities in patients with colorectal cancer (CRC). The MEDLINE (1966∼2013), the Cochrane Library Database (Issue 12, 2013), EMBASE (1980∼2013), CINAHL (1982∼2013), Web of Science (1945∼2013), and the Chinese Biomedical Database (CBM) (1982∼2013) were searched without language restrictions. Meta-analyses were conducted with the use of STATA software (Version 12.0, Stata Corporation, College Station, TX, USA). Seven clinical cohort studies with a total of 946 CRC patients met our inclusion criteria, and NOS scores of each of the included studies were ≥5. Our findings showed thatDPYDgenetic polymorphisms were significantly correlated with high incidences of 5-FU-related toxicity in CRC patients. SNP-stratified analysis indicated that there were remarkable connections of IVS14+1G>A, 464T>A, and 2194G>A polymorphisms with the incidence of marrow suppression in CRC patients receiving 5-FU chemotherapy. Furthermore, we found that IVS14+1G>A, 496A>G, and 2194G>A polymorphisms were correlated with the incidence of gastrointestinal reaction. Ethnicity-stratified analysis also revealed thatDPYDgenetic polymorphisms might contribute to the development of marrow suppression and gastrointestinal reaction among Asians, but not among Caucasians. The present meta-analysis suggests thatDPYDgenetic polymorphisms may be correlated with the incidence of 5-FU-related toxicity in CRC patients.

Robotic-Assisted vs. Open Simple Prostatectomy for Large Prostates: A Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.695318 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zhongyou Xia ◽

Jinze Li ◽

Xiaoying Yang ◽

Hao Jing ◽

Chao Niu ◽

...

Keyword(s):

Meta Analysis ◽

Similar Efficacy ◽

Prostatic Hyperplasia ◽

Cochrane Library ◽

Efficacy And Safety ◽

Robotic Assisted ◽

Simple Prostatectomy ◽

The Cochrane Library ◽

Large Prostate ◽

Purpose: To compare the efficacy and safety of robotic-assisted simple prostatectomy and open simple prostatectomy for large benign prostatic hyperplasia.Methods: We systematically searched the Cochrane Library, PubMed, Embase, and Science databases for studies published through December 2020. Controlled trials on RASP and OSP for large prostates were included. The meta-analysis was conducted with the Review Manager 5.4 software.Results: A total of seven studies with 3,777 patients were included in the analysis. There were no significant differences in IPSS (WMD, 0.72; 95%CI: −0.31, 1.76; P = 0.17), QoL (WMD, 0.00; 95%CI: −0.39, 0.39; P > 0.99), Qmax (WMD, 1.88; 95% CI: −1.15, 4.91; P = 0.22), or PVR (WMD, −10.48; 95%CI: −25.13, 4.17; P = 0.16) among patients undergoing RASP and OSP. However, compared with patients who underwent OSP, patients who underwent RASP had a shorter LOS (WMD, −2.83; 95%CI: −3.68, −1.98; P < 0.001), less EBL (WMD, −304.68; 95% CI: −432.91, −176.44; P < 0.001), a shorter CT (WMD, −2.61; 95%CI: −3.94, −1.29; P < 0.001), and fewer overall complications (OR, 0.30; 95% CI: 0.16, 0.57; P < 0.001). Nevertheless, RASP was associated with a longer OT (WMD, 59.69, 95% CI: 49.40, 69.98; P < 0.001).Conclusion: The results of the current study demonstrated that RASP provided similar efficacy to those of OSP in the treatment of large prostate, while maintaining better security. Our findings indicate that RASP is a feasible and effective alternative to OSP.

Effects of aerobic exercise on obese children with metabolic syndrome: a systematic review and meta-analysis

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0295 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Youxiang Cao ◽

Lin Zhu ◽

Jingxin Liu

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Aerobic Exercise ◽

Meta Analysis ◽

Density Lipoprotein ◽

Exercise Group ◽

Cochrane Library ◽

Obese Children ◽

Meta Analyses ◽

Abstract Objectives Metabolic syndrome (MetS) is systemic metabolic disease that results from insulin resistance or obesity. Numerous meta-analyses have investigated the effect of exercise on different populations, but none were aimed at the effect of aerobic exercise alone on obese children. This review systematically assessed and performed a meta-analysis on the effect of aerobic exercise on obese children with MetS. Content MEDLINE via PubMed, Embase, SPORTDiscus, and the Cochrane library were searched and screened from inception to 20 October 2020 for randomized controlled trials. The inclusion criteria were obese children who met the criteria for MetS and aged 5–19 years old in an aerobic exercise group. The meta-analysis included eight trials with a total of 197 participants. Aerobic exercise significantly improved the waist circumference (mean difference [MD]=−3.97; 95% confidence interval [CI]=−6.12 to −1.83; p<0.01), body mass index (standardized MD [SMD]=−0.5; 95% CI=−0.70 to −0.29; p<0.01), triglyceride (SMD=−24.6; 95% CI=−33.85 to −15.35; p<0.01), high-density lipoprotein cholesterol (SMD=2.36; 95% CI=0.44 to 4.27; p<0.01), and systolic blood pressure (SMD=−6.90; 95% CI=−10.46 to −3.35; p<0.01). Summary Based on the results of this meta-analysis, during the intervention period of the included studies, aerobic exercise alone mainly affected the lipoprotein, blood pressure, and body dimensions but cannot completely cure the MetS of obese children. Outlook The effects of different types of aerobic exercise on obese children with MetS and exercise dose to cure the MetS of obese children needs to be further studied.

Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.157 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S290-S291 ◽

Cited By ~ 3

Author(s):

R. Calati ◽

V. Di Mattei ◽

P. Courtet

Keyword(s):

Suicide Risk ◽

Meta Analysis ◽

Suicide Mortality ◽

Cochrane Library ◽

Case Control Studies ◽

Patients With Cancer ◽

Competing Interest ◽

Trim And Fill ◽

Meta Analyses ◽

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.