ObjectivesTo systematically review the efficacy of folic acid supplementation in the primary prevention of stroke among patients with H-Type hypertension.MethodsPubMed, EMbase, The Cochrane Library, WanFang Data, CNKI, VIP and Sinomed databases were electronically searched to collect randomized controlled trials (RCTs) of folic acid supplementation in the primary prevention of stroke among patients with H-Type hypertension from inception to April, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software and Stata 12.0 software.ResultsA total of 12 RCTs involving 18 170 participants were included. The results of meta-analysis showed that H-Type hypertensive patients who received folic acid and antihypertensive had a significant low risk of stroke (RR=0.34, 95%CI 0.21 to 0.55, P<0.000 1) compared with patients who received antihypertensive alone. In the stratified analyses, folic acid >2 mg/d (RR=0.27, 95%CI 0.14 to 0.51, P<0.000 1) and ≤2 mg/d (RR=0.36, 95%CI 0.20 to 0.65, P=0.000 8) both could reduce the risk of stroke. Enalapril folic acid tablets (RR=0.35, 95%CI 0.16 to 0.77, P=0.009) and free combinations of folic acid and antihypertensive drugs (RR=0.29, 95%CI 0.18 to 0.47, P<0.000 01) could lower the incidence of stroke.ConclusionsCurrent evidence shows that the folic acid supplementation significantly reduce the risk of stroke among patients with H-Type hypertension. Enalapril folic acid tablets and free combinations of folic acid with antihypertensive drugs both play an important role in stroke prevention. There is no significant dose-response relationship between dosage of folic acid and prevention of stroke. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
ObjectiveTo systematically review the relationship between systemic immune inflammatory index (SII) and the prognosis of coronary heart disease. MethodsThe CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, Ovid, Cochrane Library and Scopus databases were electronically searched to collect cohort studies related to the relationship between SII and the prognosis of patients with coronary heart disease from inception to December 10, 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 15.0 software. ResultsA total of 7 cohort studies involving 18 413 patients were included. The results of meta-analysis showed that the group of high level SII was higher risk of major adverse cardiovascular events (MACE) (OR=2.2, 95%Cl 1.5 to 3.3, P<0.01), all-cause death (OR=2.0, 95%Cl 1.1 to 3.4, P=0.02), and cardiogenic death (OR=2.4, 95%Cl 1.5 to 3.9, P<0.01) than the group of low level SII. However, no significant difference was found in the risk of re-hospitalization for heart failure. ConclusionThe current evidence shows that high levels of SII can increase the risk of MACE, all-cause death and cardiogenic death in patients with coronary heart disease. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.