scholarly journals Nurse-Coordinated Blood Pressure Telemonitoring for Urban Hypertensive Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (13) ◽  
pp. 6892
Author(s):  
Woo-Seok Choi ◽  
Nam-Suk Kim ◽  
Ah-Young Kim ◽  
Hyung-Soo Woo
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Intervention Group ◽  
Home Blood Pressure ◽  
Hypertensive Patients ◽  
Increased Risk ◽  
Over Time

Coronavirus disease 2019 (COVID-19) has put hypertensive patients in densely populated cities at increased risk. Nurse-coordinated home blood pressure telemonitoring (NC-HBPT) may help address this. We screened studies published in English on three databases, from their inception to 30 November 2020. The effects of NC-HBPT were compared with in-person treatment. Outcomes included changes in blood pressure (BP) following the intervention and rate of BP target achievements before and during COVID-19. Of the 1916 articles identified, 27 comparisons were included in this review. In the intervention group, reductions of 5.731 mmHg (95% confidence interval: 4.120–7.341; p < 0.001) in systolic blood pressure (SBP) and 2.342 mmHg (1.482–3.202; p < 0.001) in diastolic blood pressure (DBP) were identified. The rate of target BP achievement was significant in the intervention group (risk ratio, RR = 1.261, 1.154–1.378; p < 0.001). The effects of intervention over time showed an SBP reduction of 3.000 mmHg (−5.999–11.999) before 2000 and 8.755 mmHg (5.177–12.334) in 2020. DBP reduced by 2.000 mmHg (−2.724–6.724) before 2000 and by 3.529 mmHg (1.221–5.838) in 2020. Analysis of the target BP ratio before 2010 (RR = 1.101, 1.013–1.198) and in 2020 (RR = 1.906, 1.462–2.487) suggested improved BP control during the pandemic. NC-HBPT more significantly improves office blood pressure than UC among urban hypertensive patients.

scholarly journals Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m3222 ◽  
Author(s):  
Dongling Luo ◽  
Yunjiu Cheng ◽  
Haifeng Zhang ◽  
Mingchuan Ba ◽  
Pengyuan Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Young Adults ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Risk Difference ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Increased Risk

AbstractObjectiveTo evaluate and quantify the future risk of cardiovascular events in young adults with high blood pressure.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, and Web of Science were searched from inception to 6 March 2020. Relative risks were pooled using a random effects model and expressed with 95% confidence intervals. Absolute risk difference was calculated. Dose-response relations between blood pressure and individual outcomes were assessed by a restricted cubic spline model.Eligibility criteria for selecting studiesStudies were selected that investigated the adverse outcomes of adults aged 18-45 with raised blood pressure. The primary study outcome was a composite of total cardiovascular events. Coronary heart disease, stroke, and all cause mortality were examined as secondary outcomes.ResultsSeventeen observational cohorts consisting of approximately 4.5 million young adults were included in the analysis. The average follow-up was 14.7 years. Young adults with normal blood pressure had increased risk of cardiovascular events compared with those with optimal blood pressure (relative risk 1.19, 95% confidence interval 1.08 to 1.31; risk difference 0.37, 95% confidence interval 0.16 to 0.61 per 1000 person years). A graded, progressive association was found between blood pressure categories and increased risk of cardiovascular events (high normal blood pressure: relative risk 1.35, 95% confidence interval 1.22 to 1.49; risk difference 0.69, 95% confidence interval 0.43 to 0.97 per 1000 person years; grade 1 hypertension: 1.92, 1.68 to 2.19; 1.81, 1.34 to 2.34; grade 2 hypertension: 3.15, 2.31 to 4.29; 4.24, 2.58 to 6.48). Similar results were observed for coronary heart disease and stroke. Generally, the population attributable fraction for cardiovascular events associated with raised blood pressure was 23.8% (95% confidence interval 17.9% to 28.8%). The number needed to treat for one year to prevent one cardiovascular event was estimated at 2672 (95% confidence interval 1639 to 6250) for participants with normal blood pressure, 1450 (1031 to 2326) for those with high normal blood pressure, 552 (427 to 746) for those with grade 1 hypertension, and 236 (154 to 388) for those with grade 2 hypertension.ConclusionsYoung adults with raised blood pressure might have a slightly increased risk of cardiovascular events in later life. Because the evidence for blood pressure lowering is limited, active interventions should be cautious and warrant further investigation.

Effects of wearable technology on patients with diabetes: A systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Dongjun Wu ◽  
Nicholas Buys ◽  
Guandong Xu ◽  
Jing Sun
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Relapse Prevention ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Intervention Group ◽  
Wearable Technologies ◽  
Patients With Diabetes ◽  
Hba1c Levels

UNSTRUCTURED Aims: This systematic review and meta-analysis aimed to evaluate the effects of wearable technologies on HbA1c, blood pressure, body mass index (BMI), and fastening blood glucose (FBG) in patients with diabetes. Methods: We searched PubMed, Scopus, Embase, the Cochrane database, and the Chinese CNKI database from last 15 years until August 2021. The quality of the 16 included studies was assessed using the PEDro scale, and random effect models were used to estimate outcomes, with I2 used for heterogeneity testing. Results: A significant reduction in HbA1c (-0.475% [95% CI -0.692 to -0.257, P<0.001]) was found following telemonitoring. However, the results of the meta-analysis did not show significant changes in blood pressure, BMI, and glucose, in the intervention group (P>0.05), although the effect size for systolic blood pressure (0.389) and diastolic blood pressure may indicate a significant effect. Subgroup analysis revealed statistically significant effects of wearable technologies on HbA1c when supported by dietetic interventions (P<0.001), medication monitoring (P<0.001), and relapse prevention (P<0.001). Online messages and telephone interventions significantly affected HbA1c levels (P<0.001). Trials with additional online face-to-face interventions showed greater reductions in HbA1c levels. Remote interventions including dietetic advice (P<0.001), medication (P<0.001), and relapse prevention (P<0.001) during telemonitoring showed a significant effect on HbA1c, particularly in patients attending ten or more intervention sessions (P<0.001). Conclusion: Wearable technologies can improve diabetes management by simplifying self-monitoring, allowing patients to upload their live measurement results frequently and thereby improving the quality of telemedicine. Wearable technologies also facilitate remote medication management, dietetic interventions, and relapse prevention.

scholarly journals Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212098245
Author(s):  
Assefa Tola Gemeda ◽  
Lemma Demissie Regassa ◽  
Adisu Birhanu Weldesenbet ◽  
Bedasa Taye Merga ◽  
Nanti Legesse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Associated Factors ◽  
Antihypertensive Medication ◽  
Meta Analysis ◽  
Group Analysis ◽  
Hypertensive Patients ◽  
Pooled Prevalence

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

scholarly journals Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis

2018 ◽  
Vol 59 (16) ◽  
pp. 2674-2687 ◽  
Author(s):  
Lukas Schwingshackl ◽  
Anna Chaimani ◽  
Carolina Schwedhelm ◽  
Estefania Toledo ◽  
Marina Pünsch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Meta Analysis ◽  
Hypertensive Patients

scholarly journals Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Yalda Bartina ◽  
Mojdeh Larti ◽  
Aliakbar Kiaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Total Sample ◽  
Policy Makers ◽  
Increased Risk ◽  
The World ◽  
Prevalence Of Osteoporosis

Abstract Background Osteoporosis is one of the most common bone system diseases that is associated with an increased risk of bone fractures and causes many complications for patients. With age, the prevalence of this disease increases so that it has become a serious problem among the elders. In this study, the prevalence of osteoporosis among elders around the world is examined to gain an understanding of its prevalence pattern. Methods In this systematic review and meta-analysis, articles that have focused on prevalence of osteoporosis in the world’s elders were searched with these key words, such as Prevalence, Osteoporosis, Elders, Older adult in the Science Direct, Embase, Scopus, PubMed, Web of Science (WoS) databases and Google Scholar search engine, and extracted without time limit until March 2020 and transferred to information management software (EndNote). Then, duplicate studies were eliminated and the remaining studies were evaluated in terms of screening, competence and qualitative evaluation based on inclusion and exclusion criteria. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2) and Begg and Mazumdar test was used to check the publication bias and I2 test was used to check the heterogeneity. Results In a review of 40 studies (31 studies related to Asia, 5 studies related to Europe and 4 studies related to America) with a total sample size of 79,127 people, the prevalence of osteoporosis in the elders of the world; 21.7% (95% confidence interval: 18.8–25%) and the overall prevalence of osteoporosis in older men and women in the world, 35.3% (95% confidence interval: 27.9–43.4%), 12.5% (95% confidence interval: 9.3–16.7%) was reported. Also, the highest prevalence of osteoporosis in the elders was reported in Asia with; 24.3% (95% confidence interval: 20.9–28.1%). Conclusion The results of the present study showed that the prevalence of osteoporosis in the elders and especially elders' women is very high. Osteoporosis was once thought to be an inseparable part of elders’ lives. Nowadays, Osteoporosis can be prevented due to significant scientific advances in its causes, diagnosis, and treatment. Regarding the growing number of elderly people in the world, it is necessary for health policy-makers to think of measures to prevent and treat osteoporosis among the elders.

Sign in / Sign up

Export Citation Format

Share Document