MilliporeSigma
  • Home
  • Search Results
  • Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials.

Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials.

Lancet (London, England) (2014-12-04)
A Ying, H Arima, S Czernichow, M Woodward, R Huxley, F Turnbull, V Perkovic, B Neal
ABSTRACT

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). 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 (<25 kg/m(2), 25 to <30 kg/m(2), and ≥30 kg/m(2)) or a continuous variable. Analyses were based on 135,715 individuals from 22 trials who had 14,353 major cardiovascular events. None of the six primary comparisons showed evidence that protection varied by drug class across the three BMI groups (all p for trend >0·20). When analysed as a continuous variable, angiotensin-converting-enzyme inhibitors gave slightly greater protection for each 5 kg/m(2) 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. 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. None.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Hydrochlorothiazide, crystalline
Sigma-Aldrich
Hydrochlorothiazide, meets USP testing specifications
Supelco
Hydrochlorothiazide, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Calcium, dendritic pieces, purified by distillation, 99.9% trace metals basis
Sigma-Aldrich
Sodium phosphate dibasic dodecahydrate, meets analytical specification of Ph. Eur., BP, E339, 98.5-102.5% (T)
Sigma-Aldrich
Sodium phosphate dibasic dodecahydrate, puriss. p.a., crystallized, ≥99.0% (T)
Hydrochlorothiazide for peak identification, European Pharmacopoeia (EP) Reference Standard
Hydrochlorothiazide, European Pharmacopoeia (EP) Reference Standard
USP
Hydrochlorothiazide, United States Pharmacopeia (USP) Reference Standard
Sigma-Aldrich
Calcium, dendritic pieces, purified by distillation, 99.5% trace metals basis
Sigma-Aldrich
Calcium, pieces, <1 cm, 99%
Sigma-Aldrich
Calcium, turnings, 99% trace metals basis
Sigma-Aldrich
Calcium, dendritic pieces, purified by distillation, 99.99% trace metals basis
Sigma-Aldrich
Calcium, granular, 99%
Sigma-Aldrich
Sodium phosphate dibasic dodecahydrate, BioXtra, ≥99.0% (T)
Sigma-Aldrich
Sodium phosphate dibasic dodecahydrate, tested according to Ph. Eur.
Dibutyl phthalate, European Pharmacopoeia (EP) Reference Standard
Supelco
Dibutyl phthalate, certified reference material, TraceCERT®
Sigma-Aldrich
Dibutyl phthalate, 99%
Supelco
Dibutyl phthalate, Selectophore
Supelco
Dibutyl phthalate, PESTANAL®, analytical standard