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Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index : A meta-analysis of randomised trials
- Source :
- The Lancet, 385(9971), 867-874. ELSEVIER SCIENCE INC, The Lancet, 385(9971), 867-874. Elsevier Limited, The Lancet, 385(9971), 867. Elsevier Limited
- Publication Year :
- 2015
-
Abstract
- Summary Background The cardiovascular benefits of blood pressure lowering in obese people compared with people of normal weight might depend on choice of drug. We compared the effects of blood pressure-lowering regimens on cardiovascular risk in groups of patients categorised by baseline body-mass index (BMI). Methods We used individual patient data from trials included in the Blood Pressure Lowering Treatment Trialists' Collaboration to compare the effects of different classes of blood pressure-lowering regimens for the primary outcome of total major cardiovascular events (stroke, coronary heart disease, heart failure, and cardiovascular death). We used meta-analyses and meta-regressions to assess interactions between treatment and BMI when fitted as either a categorical variable (0·20). When analysed as a continuous variable, angiotensin-converting-enzyme inhibitors gave slightly greater protection for each 5 kg/m2 higher BMI than did calcium antagonists (hazard ratio 0·93, 95% CI 0·89-0·98; p=0·004) or diuretics (0·93, 0·89-0·98; p=0·002). The meta-regressions showed no relation between BMI category and the risk reduction for a given fall in systolic blood pressure. By contrast with a previous report, we noted no relation between BMI and the efficacy of calcium antagonists compared with diuretics. Interpretation We found little evidence that selection of a particular class of blood pressure-lowering drug will lead to substantially different outcomes for individuals who are obese compared with those who are lean. Funding None.
- Subjects :
- medicine.medical_specialty
DISEASE
Body Mass Index
EVENTS
Internal medicine
medicine
Humans
Obesity
Stroke
Antihypertensive Agents
METABOLIC SYNDROME
Randomized Controlled Trials as Topic
Medicine(all)
business.industry
MORTALITY
Hazard ratio
General Medicine
medicine.disease
PREVENTION
EUROPEAN-SOCIETY
PROSPECTIVELY-DESIGNED OVERVIEWS
REDUCTION
Blood pressure
Cardiovascular Diseases
Heart failure
Meta-analysis
Hypertension
Physical therapy
Metabolic syndrome
business
Body mass index
Risk Reduction Behavior
Subjects
Details
- Language :
- English
- ISSN :
- 01406736
- Database :
- OpenAIRE
- Journal :
- The Lancet, 385(9971), 867-874. ELSEVIER SCIENCE INC, The Lancet, 385(9971), 867-874. Elsevier Limited, The Lancet, 385(9971), 867. Elsevier Limited
- Accession number :
- edsair.doi.dedup.....fa37d4d553ceb831d9f6ab5ef3de3115