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Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality.

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Title: Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality.
Authors: Jenkins, David J A, Sahye-Pudaruth, Sandhya, Khodabandehlou, Khosrow, Liang, Fred, Kasmani, Maaria, Wanyan, Jessica, Wang, Maggie, Selvaganesh, Keishini, Paquette, Melanie, Patel, Darshna, Glenn, Andrea J, Srichaikul, Korbua, Kendall, Cyril W C, Sievenpiper, John L
Source: American Journal of Clinical Nutrition; Sep2022, Vol. 116 Issue 3, p663-671, 9p, 3 Charts
Subject Terms: MORTALITY risk factors, CARDIOVASCULAR diseases risk factors, MEDICAL databases, META-analysis, MEDICAL information storage & retrieval systems, STROKE, MAJOR adverse cardiovascular events, SYSTEMATIC reviews, RISK assessment, HYPOTENSION, MEDLINE, DISEASE risk factors, DISEASE complications
Abstract: Background Postprandial hypotension (PPH) has been reported to be associated with syncope, falls, adverse cardiovascular outcomes, and increased all-cause mortality. It has been reported to have an incidence as high as 30% in the elderly and persons with diabetes. We therefore performed a meta-analysis to determine the relation of PPH with cardiovascular disease (CVD) events and all-cause mortality. Objectives Our objective was to conduct a systematic review and meta-analysis of cohort and cross-sectional studies to determine the association of PPH with CVD and all-cause mortality. Methods We searched the databases MEDLINE, EMBASE, and Cochrane library up to 13 April 2022 for prospective cohort and cross-sectional studies that examined the association of PPH with CVD outcomes and all-cause mortality. Data were analyzed using the generic inverse variance method with a random-effects model. Grading of Recommendations, Assessment, Development, and Evaluation approach assessed the certainty of evidence. Results Seven studies that included 2389 participants met our inclusion criteria. PPH was associated with each outcome individually, including increased all-cause mortality, total CVD, CVD mortality, and stroke. CVD outcomes and all-cause mortality combined were also associated with PPH (RR: 1.52; 95% CI: 1.05, 2.18; P  = 0.03; I 2 = 77%). The certainty of evidence was graded as very low due to significant heterogeneity and the limited number of studies. Conclusions This assessment indicates an association of PPH with CVD and all-cause mortality. Further studies are required to improve CVD and mortality estimates, but the potential seriousness of CVD and all-cause mortality as outcomes of PPH justifies more screening, diagnosis, and research. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Clinical Nutrition is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality.
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  Data: <searchLink fieldCode="AR" term="%22Jenkins%2C+David+J+A%22">Jenkins, David J A</searchLink><br /><searchLink fieldCode="AR" term="%22Sahye-Pudaruth%2C+Sandhya%22">Sahye-Pudaruth, Sandhya</searchLink><br /><searchLink fieldCode="AR" term="%22Khodabandehlou%2C+Khosrow%22">Khodabandehlou, Khosrow</searchLink><br /><searchLink fieldCode="AR" term="%22Liang%2C+Fred%22">Liang, Fred</searchLink><br /><searchLink fieldCode="AR" term="%22Kasmani%2C+Maaria%22">Kasmani, Maaria</searchLink><br /><searchLink fieldCode="AR" term="%22Wanyan%2C+Jessica%22">Wanyan, Jessica</searchLink><br /><searchLink fieldCode="AR" term="%22Wang%2C+Maggie%22">Wang, Maggie</searchLink><br /><searchLink fieldCode="AR" term="%22Selvaganesh%2C+Keishini%22">Selvaganesh, Keishini</searchLink><br /><searchLink fieldCode="AR" term="%22Paquette%2C+Melanie%22">Paquette, Melanie</searchLink><br /><searchLink fieldCode="AR" term="%22Patel%2C+Darshna%22">Patel, Darshna</searchLink><br /><searchLink fieldCode="AR" term="%22Glenn%2C+Andrea+J%22">Glenn, Andrea J</searchLink><br /><searchLink fieldCode="AR" term="%22Srichaikul%2C+Korbua%22">Srichaikul, Korbua</searchLink><br /><searchLink fieldCode="AR" term="%22Kendall%2C+Cyril+W+C%22">Kendall, Cyril W C</searchLink><br /><searchLink fieldCode="AR" term="%22Sievenpiper%2C+John+L%22">Sievenpiper, John L</searchLink>
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  Data: American Journal of Clinical Nutrition; Sep2022, Vol. 116 Issue 3, p663-671, 9p, 3 Charts
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background Postprandial hypotension (PPH) has been reported to be associated with syncope, falls, adverse cardiovascular outcomes, and increased all-cause mortality. It has been reported to have an incidence as high as 30% in the elderly and persons with diabetes. We therefore performed a meta-analysis to determine the relation of PPH with cardiovascular disease (CVD) events and all-cause mortality. Objectives Our objective was to conduct a systematic review and meta-analysis of cohort and cross-sectional studies to determine the association of PPH with CVD and all-cause mortality. Methods We searched the databases MEDLINE, EMBASE, and Cochrane library up to 13 April 2022 for prospective cohort and cross-sectional studies that examined the association of PPH with CVD outcomes and all-cause mortality. Data were analyzed using the generic inverse variance method with a random-effects model. Grading of Recommendations, Assessment, Development, and Evaluation approach assessed the certainty of evidence. Results Seven studies that included 2389 participants met our inclusion criteria. PPH was associated with each outcome individually, including increased all-cause mortality, total CVD, CVD mortality, and stroke. CVD outcomes and all-cause mortality combined were also associated with PPH (RR: 1.52; 95% CI: 1.05, 2.18; P  = 0.03; I <superscript>2</superscript> = 77%). The certainty of evidence was graded as very low due to significant heterogeneity and the limited number of studies. Conclusions This assessment indicates an association of PPH with CVD and all-cause mortality. Further studies are required to improve CVD and mortality estimates, but the potential seriousness of CVD and all-cause mortality as outcomes of PPH justifies more screening, diagnosis, and research. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of American Journal of Clinical Nutrition is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1093/ajcn/nqac158
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      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 663
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        Type: general
      – SubjectFull: CARDIOVASCULAR diseases risk factors
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      – SubjectFull: MEDICAL databases
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      – SubjectFull: SYSTEMATIC reviews
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      – SubjectFull: RISK assessment
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      – SubjectFull: HYPOTENSION
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      – SubjectFull: MEDLINE
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      – SubjectFull: DISEASE risk factors
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      – SubjectFull: DISEASE complications
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              Text: Sep2022
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