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Clinical Summary

Hypertension and risk for sudden cardiac death

Takeaway

  • This meta-analysis found an increased risk for sudden cardiac death (SCD) with hypertension diagnosis and increasing systolic blood pressure (SBP).
  • No association was observed between diastolic BP (DBP) and SCD.

Why this matters

  • Elevated BP and hypertension have been associated with increased risk of SCD, but the findings have not been consistent.

Study design

  • Meta-analysis included 18 studies after a search across PubMed and Embase databases.
  • Funding: None disclosed.

Key results

  • Prevalent hypertension (relative risk [RR], 2.10; 95% CI, 1.71-2.58; I2=56.7%) and each 20-mmHg increase in SBP (RR, 1.28; 95% CI, 1.19-1.38) were associated with an increased risk for SCD.
  • No association was observed between each 10-mmHg increase in DBP and risk for SCD (RR, 1.09; 95% CI, 0.83-1.44; I2=83.4%).
  • In sensitivity analysis:
    • The risk for SCD was higher with prevalent hypertension (RR, 2.00; 95% CI, 1.52-2.63; I2=88.0%) and each 20-mmHg increase in SBP (RR, 1.25; 95% CI, 1.15-1.36; I2=63.9%).
    • No association was observed between each 10-mmHg increase in DBP and risk for SCD (RR, 1.08; 95% CI, 0.92-1.27; I2=77.4%).

Limitations

  • Heterogeneity among studies.
  • Risk for potential confounding.

References


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