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Meta-Analysis
. 2017 Jan 25;12(1):e0170218.
doi: 10.1371/journal.pone.0170218. eCollection 2017.

Assessing Sex Differences in the Risk of Cardiovascular Disease and Mortality per Increment in Systolic Blood Pressure: A Systematic Review and Meta-Analysis of Follow-Up Studies in the United States

Yu-Chung Wei  1   2 , Nysia I George  1 , Ching-Wei Chang  1   3 , Karen A Hicks  4
Affiliations
Meta-Analysis

Assessing Sex Differences in the Risk of Cardiovascular Disease and Mortality per Increment in Systolic Blood Pressure: A Systematic Review and Meta-Analysis of Follow-Up Studies in the United States

Yu-Chung Wei et al. PLoS One. .

Abstract

In the United States (US), cardiovascular (CV) disease accounts for nearly 20% of national health care expenses. Since costs are expected to increase with the aging population, informative research is necessary to address the growing burden of CV disease and sex-related differences in diagnosis, treatment, and outcomes. Hypertension is a major risk factor for CV disease and mortality. To evaluate whether there are sex-related differences in the effect of systolic blood pressure (SBP) on the risk of CV disease and mortality, we performed a systematic review and meta-analysis. We conducted a comprehensive search using PubMed and Google Scholar to identify US-based studies published prior to 31 December, 2015. We identified eight publications for CV disease risk, which provided 9 female and 8 male effect size (ES) observations. We also identified twelve publications for CV mortality, which provided 10 female and 18 male ES estimates. Our meta-analysis estimated that the pooled ES for increased risk of CV disease per 10 mmHg increment in SBP was 25% for women (95% Confidence Interval (CI): 1.18, 1.32) and 15% for men (95% CI: 1.11, 1.19). The pooled increase in CV mortality per 10 mm Hg SBP increment was similar for both women and men (Women: 1.16; 95% CI: 1.10, 1.23; Men: 1.17; 95% CI: 1.12, 1.22). After adjusting for age and baseline SBP, the results demonstrated that the risk of CV disease per 10 mm Hg SBP increment for women was 1.1-fold higher than men (P<0.01; 95% CI: 1.04, 1.17). Heterogeneity was moderate but significant. There was no significant sex difference in CV mortality.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of publication selection process.
Fig 2
Fig 2. Sex-specific and overall effect sizes (ES) for CV disease risk per 10 mm Hg increment in SBP.
ES observations are ordered by baseline SBP values. The corresponding ES IDs are listed in Table 1.
Fig 3
Fig 3. Sex-specific and overall effect sizes (ES) for CV mortality per 10 mm Hg increment in SBP.
ES observations are ordered by baseline SBP values. The corresponding ES IDs are listed in Table 2.
See this image and copyright information in PMC

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