Characteristics and Methodological Quality of Meta-Analyses on Hypertension Treatments-A Cross-Sectional Study

Abstract

Methodological quality of meta-analyses on hypertension treatments can affect treatment decision-making. The authors conducted a cross-sectional study to investigate the methodological quality of meta-analyses on hypertension treatments. One hundred and fifty-eight meta-analyses were identified. Overall, methodological quality was unsatisfactory in the following aspects: comprehensive reporting of financial support (1.9%), provision of included and excluded lists of studies (22.8%), inclusion of grey literature (27.2%), and inclusion of protocols (32.9%). The 126 non-Cochrane meta-analyses had poor performance on almost all the methodological items. Non-Cochrane meta-analyses focused on nonpharmacologic treatments were more likely to consider scientific quality of included studies when making conclusions. The 32 Cochrane meta-analyses generally had good methodological quality except for comprehensive reporting of the sources of support. These results highlight the need for cautious interpretation of these meta-analyses, especially among physicians and policy makers when guidelines are formulated. Future meta-analyses should pay attention to improving these methodological aspects.

Figure 1

Sampling of meta‐analyses on hypertension treatments: flow chart. The literature search yielded 727 citations. Six duplicates or protocols were excluded, leaving 721 records for screening. Four hundred forty‐nine citations were excluded based on title and abstract. The remaining 272 records went through full‐text assessment. Fourteen narrative reviews, 43 systematic reviews without any meta‐analysis, and 57 meta‐analyses assessing the effect of blood pressure on health population were excluded during full‐text assessment. Finally, 158 meta‐analyses were included in this cross‐sectional study.