From the Guidelines
The baseline characteristics of this meta-analysis included 25 studies with a total of 64,162 participants without hypertension, with a mean age ranging from 55.0 to 68.0 years and 76% of study participants being men. The studies included in the meta-analysis had varying entry criteria, but all required a history of cardiovascular disease (CVD); clinical evidence of recent myocardial infarction (MI), congestive heart failure (CHF), coronary artery disease, or stroke; or CVD equivalent such as type 2 diabetes 1. The class and dose of medication administered in the antihypertensive treatment group varied between studies, but for most studies, it progressively increased to a defined target dose. Some key characteristics of the participants include:
- Mean age: 55.0 to 68.0 years
- Gender: 76% men
- Clinical history: MI, CHF, diabetes, stroke, and coronary artery disease at baseline varied between studies
- Study duration: ranged from a mean length of 1.5 to 63 months The meta-analysis found that antihypertensive treatment was associated with a significant reduction in risk for fatal or nonfatal stroke, CHF events, composite CVD events, and all-cause mortality 1. The results of this meta-analysis suggest that persons with compelling indications but without hypertension may also benefit from reduced morbidity and mortality attributable to CVD events when treated with antihypertensive medications 1. However, the findings should be interpreted with caution due to the limited number of studies and potential publication bias 1. Overall, the baseline characteristics of this meta-analysis provide valuable insights into the effects of antihypertensive treatment on CVD events and all-cause mortality in persons without hypertension.
From the FDA Drug Label
In this double-blind, placebo-controlled trial, patients were treated with anti-hypertensive therapy (goal BP <140/90 mm Hg for patients without diabetes; <130/80 mm Hg for patients with diabetes) and allocated to either atorvastatin calcium 10 mg daily (n=5,168) or placebo (n=5,137), using a covariate adaptive method which took into account the distribution of nine baseline characteristics of patients already enrolled and minimized the imbalance of those characteristics across the groups. Baseline characteristics of subjects were: mean age of 62 years, mean HbA1c 7. 7%; median LDL-C 120 mg/dL; median TC 207 mg/dL; median TG 151 mg/dL; median HDL-C 52 mg/dL.
The baseline characteristics of the meta-analysis are not directly provided in the given text. However, based on the information from the Collaborative Atorvastatin Diabetes Study (CARDS), the baseline characteristics of the subjects include:
- Mean age: 62 years
- Mean HbA1c: 7.7%
- Median LDL-C: 120 mg/dL
- Median TC: 207 mg/dL
- Median TG: 151 mg/dL
- Median HDL-C: 52 mg/dL 2
From the Research
Baseline Characteristics of the Meta-Analysis
The meta-analysis in question, available at https://pmc.ncbi.nlm.nih.gov/articles/PMC11153294/, does not provide direct information on its baseline characteristics within the given text. However, based on the provided evidence from various studies, we can infer some general baseline characteristics that might be relevant to a meta-analysis on hypertension treatment:
- Patient Population:
- Interventions:
- Lifestyle modifications are considered first-line therapy, including weight loss, healthy dietary patterns (low sodium, high potassium), physical activity, and moderation or elimination of alcohol consumption 3.
- First-line drug therapies include thiazide or thiazide-like diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs) 3, 4.
- Outcomes:
- The primary outcomes often measured are systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, with targets such as SBP/DBP <130/80 mm Hg for adults <65 years and SBP <130 mm Hg for adults ≥65 years 3.
- Reduction in the risk of cardiovascular disease (CVD) events, such as coronary heart disease, heart failure, and stroke, is a critical outcome 3, 4.
- Study Designs:
- Randomized controlled trials (RCTs) are commonly used to evaluate the efficacy of different antihypertensive therapies and their combinations with statins for managing hypertension and hypercholesterolemia 4.
- Systematic reviews and meta-analyses are utilized to synthesize evidence from multiple studies, providing a comprehensive overview of the effectiveness of various treatments 4, 5.
Specifics from Relevant Studies
- Hypertension Treatment: A study from 2022 3 emphasizes the importance of lifestyle modification and the use of specific drug therapies like ACEIs, ARBs, and CCBs as first-line treatments.
- Combination Therapies: The 2024 study 4 compares the effectiveness of novel combination therapies for simultaneous management of hypertension and hypercholesterolemia, highlighting the benefits of combining antihypertensives with statins.
- Antihypertensive Drugs: An older study from 2001 6 compares the efficacy of different antihypertensive drug classes (ACE inhibitors, beta-blockers, calcium blockers, and diuretics) in lowering systolic blood pressure in elderly patients.
- Meta-Analysis Basics: A 2020 review article 5 provides an overview of the principles and steps involved in conducting a systematic review and meta-analysis, which is essential for understanding how baseline characteristics are determined and analyzed in such studies.
- Medications and ALS Risk: A 2022 systematic review and meta-analysis 7 investigates the association between medications for hypertension, hyperlipidemia, diabetes, and the risk of amyotrophic lateral sclerosis (ALS), finding protective effects of certain antihypertensive and antidiabetic drugs.