Evaluating Sex-Based Differences in the Relationship Between Hypertension and CVD Risk: a Meta-Analysis of US-Based Studies

• Activity Number: 127 - Statistical Applications in Epidemiology
• Type: Contributed
• Date/Time: Monday, July 31, 2017 : 8:30 AM to 10:20 AM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Nysia George* and Karen Hicks and Ching-Wei Chang and Yu-Chung Wei
• Companies: US FDA, National Center for Toxicological Research and Center for Drug Evaluation and Research, FDA and Genentech, Inc. and Department of Statistics, Feng Chia University
• Keywords: systolic blood pressure ; cardiovascular disease ; meta-analysis ; sex differences

Abstract

Cardiovascular disease (CV) is the leading cause of death globally. In the United States (US), CV expenses account for nearly 20% of the national healthcare budget. The US spends considerably more on healthcare yet ranks lower in measures of health. As the population ages, the prevalence of CV disease and its associated costs are expected to increase. Studies have indicated systolic blood pressure (SBP) as a strong predictor for CV disease, but there is no consensus regarding whether this relationship varies by sex. Thus, we conducted a meta-analysis to evaluate sex-based differences in the relationship between SBP and the risk of CV disease and mortality for the US population. We identified eight CV disease risk studies and 12 CV mortality studies. The pooled effect size for increased risk of CV disease per 10 mm Hg SBP increment was 15% (95% CI: 1.11, 1.19) and 25% (95% CI: 1.18, 1.32) for men and women, respectively. Results of the meta-regression analysis indicated that the risk of CV disease per 10 mm Hg SBP increment was 1.1 times higher (95% CI: 1.04, 1.17) in women than men, after adjusting for age and baseline SBP. There was no significant sex difference in CV mortality.