Central hemodynamic parameters to predict cardiovascular outcomes and mortality among the elderly

protocol for a systematic review

Authors

Keywords:

Blood pressure, Hypertension, Aged, Mortality

Abstract

BACKGROUND: Central blood pressure is a factor that may predict cardiovascular events. However, its use in clinical practice is not well consolidated. Therefore, the aim of our study will be to summarize the use of central hemodynamic parameters to predict cardiovascular-related outcomes and all-cause mortality. DESIGN AND SETTING: Protocol for systematic review of longitudinal observational studies conducted in healthcare institutions, as presented in the studies included. METHODS: We will perform a systematic search in the electronic databases MEDLINE (via PubMed), EMBASE and LILACS (via Virtual Health Library (VHL)), using health descriptors terms for elderly people and for hemodynamic indices of central blood pressure. We will include articles that evaluated hemody- namic indices and at least one of the following outcomes: all-cause mortality, total cardiovascular death, total non-cardiovascular death, myocardial infarction, stroke, coronary artery restenosis after percutaneous coronary intervention, revascularization and aortic syndromes. Two independent reviewers will conduct analysis on the abstracts selected and on the full-text articles. Two reviewers will independently perform data extraction and evaluate the methodological quality of the articles selected, and a third reviewer will evaluate any divergences. The methodological quality of the studies will be assessed in accordance with the ROBINS-I tool (Risk Of Bias In Non-randomized Studies of Interventions). RESULTS AND CONCLUSIONS: Through this systematic review, we intend to summarize evidence that supports the use of central hemodynamic parameters for central blood pressure to diagnose and perform prognostics on arterial hypertension in elderly patients within clinical practice and predict future cardio- vascular events in this population. REGISTRATION: Prospero - CRD42018085264.

Downloads

Download data is not yet available.

Author Biographies

Grasiele Sausen, Fundação Universitária de Cardiologia

PhD. Coordinator of the Experimental Research Section, Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia (IC-FUC), Porto Alegre (RS), Brazil.

Tarsila Vieceli, Universidade Federal de Ciências da Saúde de Porto Alegre

MSc. Medical Student, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil.

Clarissa Garcia Rodrigues, Global Research and Innovation Network

PhD. Chief Executive Officer, Board of Directors, Global Research and Innovation Network (GRINN), Porto Alegre (RS), Brazil.

Daniel Kipper, Clínica Del Cuore

MD. Physician, Clínica Del Cuore, Antonio Prado (RS), Brazil.

Airton Tetelbom Stein

PhD. Provost of Research and Graduate Programs. Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil.

Guilherme Brasil Grezzana, Clínica Del Cuore

hD. Physician and Director, Clínica Del Cuore, Antonio Prado (RS), Brazil.

References

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13. PMID: 12493255.

Mancia G, Fagard R, Narkiewicz K, et al. 2013 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-357. PMID: 23817082; doi: 10.1097/01. hjh.0000431740.32696.cc.

Huang CM, Wang KL, Cheng HM, et al. Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities. J Hypertens. 2011;29(3):454-9. PMID: 21252703; doi: 10.1097/HJH.0b013e3283424b4d.

McEniery CM, Yasmin, McDonnell B, et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension. 2008 Jun 1;51(6):1476-82. PMID: 18426997; doi: 10.1161/HYPERTENSIONAHA.107.105445.

Roman MJ, Devereux RB, Kizer JR, et al. High central pulse pressure is independently associated with adverse cardiovascular outcome the strong heart study. J Am Coll Cardiol. 2009;54(18):1730-4. PMID: 19850215; doi: 10.1016/j.jacc.2009.05.070.

Vlachopoulos C, Aznaouridis K, O’Rourke MF, et al. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010;31(15):1865-71. PMID: 20197424; doi: 10.1093/eurheartj/ehq024.

Williams B, Lacy PS, Thom SM, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006 Mar 7;113(9):1213–25. PMID: 16476843; doi: 10.1161/CIRCULATIONAHA.105.595496.

Borghi C, Acelajado MC, Gupta Y, Jain S. Role of nebivolol in the control and management of central aortic blood pressure in hypertensive patients. J Hum Hypertens. 2017;31(10):605-10. PMID: 28382958; doi: 10.1038/jhh.2017.26.

Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-12. PMID: 10789670.

PROSPERO: International prospective register of systematic reviews [Internet]. Available from: https://www.crd.york.ac.uk/PROSPERO/. Accessed in 2018 (May 2).

Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355: i4919. PMID: 27733354; doi: 10.1136/bmj.i4919.

GRADEpro | GDT [Internet]. Available from: https://gradepro.org/. Accessed in 2018 (May 2).

Losilla JM, Oliveras I, Marin-Garcia JA, Vives J. Three risk of bias tools lead to opposite conclusions in observational research synthesis. J Clin Epidemiol. 2018;101:61-72. PMID: 29864541; doi: 10.1016/j. jclinepi.2018.05.021.

The ROBINS-E Tool (Risk of Bias In Non-Randomized Studies – of Exposures) [Internet]. Available from: http://www.bristol.ac.uk/population-health-sciences/centres/cresyda/barr/riskofbias/robins-e/. Accessed in 2018 (October 2).

Lo CK, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14:45. PMID: 24690082; doi: 10.1186/1471-2288-14-45.

Hartling L, Milne A, Hamm MP, et al. Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers. J Clin Epidemiol. 2013;66(9):982-93. PMID: 23683848; doi: 10.1016/j.jclinepi.2013.03.003.

Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-5. PMID: 20652370; doi: 10.1007/s10654-010-9491-z.

Downloads

Published

2018-12-06

How to Cite

1.
Grasiele Sausen, Vieceli T, Rodrigues CG, Kipper D, Stein AT, Grezzana GB. Central hemodynamic parameters to predict cardiovascular outcomes and mortality among the elderly: protocol for a systematic review. Sao Paulo Med J [Internet]. 2018 Dec. 6 [cited 2025 Mar. 9];136(6):501-4. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/614

Issue

Section

Original Article