0
selected
-
1.
Interleukin-6 as a Predictor of the Risk of Cardiovascular Disease: A Meta-Analysis of Prospective Epidemiological Studies.
Zhang, B, Li, XL, Zhao, CR, Pan, CL, Zhang, Z
Immunological investigations. 2018;(7):689-699
Abstract
OBJECTIVE The etiology of cardiovascular disease (CVD) is complex owing to the interactions of genetic variance with environmental factors. Inflammatory processes are now being increasingly implicated in the pathogenesis of CVD. This meta-analysis investigated the potential role of interleukin-6 (IL-6) as a risk factor for CVD development in healthy individuals. METHODS Literature search was carried out in multiple electronic databases, and study selection followed a priori eligibility criteria. Meta-analyses of standardized mean differences were carried out to determine an overall effect size of the difference in IL-6 levels between CVD cases and non-CVD matched controls. Meta-regression analyses were performed to examine the relationship between the IL-6 levels in CVD cases and several explanatory variables. RESULTS Seventeen studies enrolling 288738 healthy individuals with an average follow-up duration of 7.4 ± 4.1 years were found eligible. Overall, data of 5400 CVD cases and 14607 matched non-CVD controls are used in the present meta-analysis. Baseline IL-6 levels were significantly higher in CVD cases than in non-CVD controls (standardized mean difference [95% confidence interval]) of 0.14 [0.09, 0.20]/mean difference of 0.36 [0.28, 0.44] picogram per milliliter). Total cholesterol, LDL-cholesterol, and triglyceride levels were also significantly higher, and HDL-cholesterol levels were significantly lower in CVD cases in comparison with the controls. Systolic blood pressure and total cholesterol levels had a significantly positive relationship, whereas triglyceride levels had a significantly inverse relationship with the levels of IL-6. CONCLUSION Higher IL-6 levels in healthy individuals are associated with CVD risk, which is co-associated with hypertension and hypercholesterolemia.
-
2.
Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials.
Dong, JY, Qin, LQ, Zhang, Z, Zhao, Y, Wang, J, Arigoni, F, Zhang, W
American heart journal. 2011;(6):959-65
Abstract
BACKGROUND Previous studies suggest that L-arginine, an amino acid and a substrate of nitric oxide synthase, may have blood pressure (BP)-lowering effect. Because some studies were performed with limited number of patients with hypertension and therefore limited statistical power with sometimes inconsistent results, we aimed to examine the effect of oral L-arginine supplementation on BP by conducting a meta-analysis of randomized, double-blind, placebo-controlled trials. METHODS PubMed, Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov databases were searched through June 2011 to identify randomized, double-blind, placebo-controlled trials of oral L-arginine supplementation on BP in humans. We also reviewed reference lists of obtained articles. Either a fixed-effects or, in the presence of heterogeneity, a random-effects model was used to calculate the combined treatment effect. RESULTS We included 11 randomized, double-blind, placebo-controlled trials involving 387 participants with oral L-arginine intervention ranging from 4 to 24 g/d. Compared with placebo, L-arginine intervention significantly lowered systolic BP by 5.39 mm Hg (95% CI -8.54 to -2.25, P = .001) and diastolic BP by 2.66 mm Hg (95% CI -3.77 to -1.54, P < .001). Sensitivity analyses restricted to trials with a duration of 4 weeks or longer and to trials in which participants did not use antihypertensive medications yielded similar results. Meta-regression analysis suggested an inverse, though insignificant (P = .13), relation between baseline systolic BP and net change in systolic BP. CONCLUSIONS This meta-analysis provides further evidence that oral L-arginine supplementation significantly lowers both systolic and diastolic BP.
-
3.
Habitual coffee consumption and risk of hypertension: a systematic review and meta-analysis of prospective observational studies.
Zhang, Z, Hu, G, Caballero, B, Appel, L, Chen, L
The American journal of clinical nutrition. 2011;(6):1212-9
-
-
Free full text
-
Abstract
BACKGROUND In 2 meta-analyses of randomized controlled trials, increased coffee intake was associated with slightly higher blood pressure. However, these trials were short in duration (<85 d). OBJECTIVE We conducted a systematic review and meta-analyses of long-term prospective studies that examined the association of habitual coffee consumption with risk of hypertension. DESIGN We searched electronic databases (MEDLINE, EMBASE, Agricola, and Cochrane Library) through August 2009 with the use of a standardized protocol. Eligible studies were prospective cohort trials that examined the association of coffee consumption with incident hypertension or blood pressure. RESULTS From 6 prospective cohort studies, a total of 172,567 participants and 37,135 incident hypertension cases were included. Mean follow-up ranged from 6.4 to 33.0 y. Compared with the lowest consumption [<1 cup (≈237 mL)/d], the pooled relative risks (RRs) for hypertension were 1.09 (95% CI: 1.01, 1.18) for the next higher category (1-3 cups/d), 1.07 (95% CI: 0.96, 1.20) for the second highest category (3-5 cups/d), and 1.08 (95% CI: 0.96, 1.21) for the highest category (>5 cups/d). A dose-response meta-analysis showed an inverse "J-shaped" curve (P for quadratic term < 0.001) with hypertension risk increasing up to 3 cups/d (RR for comparison of 3 with 0 cups/d: 1.07; 95% CI: 0.97, 1.20) and decreasing with higher intakes (RR for comparison of 6 with 0 cups/d: 0.99; 95% CI: 0.89, 1.10). CONCLUSION The results suggest that habitual coffee consumption of >3 cups/d was not associated with an increased risk of hypertension compared with <1 cup/d; however, a slightly elevated risk appeared to be associated with light-to-moderate consumption of 1 to 3 cups/d.
-
4.
Atenolol as a comparator in outcome trials in hypertension: a correct choice in the past, but not for the future?
Dahlöf, B, Devereux, RB, Kjeldsen, SE, Lyle, PA, Zhang, Z, Edelman, JM
Blood pressure. 2007;(1):6-12
Abstract
OBJECTIVE Twelve years after the design of the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, which showed superiority of losartan- vs atenolol-based therapy for cardiovascular outcomes, we reviewed the literature for the effect of beta-blockers compared with initial placebo or no treatment on reduction of cardiovascular events to re-evaluate atenolol as the comparator in the LIFE study. METHODS A literature search was conducted in September 2006 for randomized, controlled trials comparing beta-blockers with/without diuretics with placebo or no treatment in patients with hypertension and without recent cardiovascular morbidity. We calculated risk reductions for combined cardiovascular events, cardiovascular death, stroke, and coronary heart disease from groups of trials using atenolol first-line and all beta-blockers first-line. RESULTS Five studies met the criteria. Significant risk reductions for cardiovascular events and stroke occurred in groups receiving treatment with atenolol or all beta-blockers, and for cardiovascular death in the all beta-blocker analysis. In meta-analysis of beta-blocker vs placebo or no treatment trials, risk reductions were 19% for combined cardiovascular events (95% CI 0.73-0.91, p<0.001), 15% for cardiovascular death (0.73-0.99, p = 0.037), 32% for stroke (0.57-0.82, p<0.001), and 10% for coronary heart disease (0.78-1.04, p = 0.146). CONCLUSIONS Beta-blocker-based antihypertensive therapy significantly reduces cardiovascular risk in hypertension compared with placebo or no treatment. Atenolol was an appropriate comparator in the LIFE study. As the results of the LIFE study and other recent trials demonstrate superiority of newer agents over atenolol, this agent is not an appropriate reference drug for future trials of cardiovascular risk in hypertension.