Response to: Association between duration of oral contraceptive use and risk of hypertension: A meta‐analysis: Methodological and statistical issues

Response to: Association between duration of oral contraceptive use and risk of hypertension: A... Dear Editor‐in‐Chief:We recently received the letter to the editor in response to our recently published work entitled Association between duration of oral contraceptive use and risk of hypertension: A meta‐analysis in the Journal of Clinical Hypertension. We appreciate the comments from Samaneh Asgari regarding this published paper. However, there are a few points that need to be addressed. First, of a total 6227 retrieved articles (6222: left box and 5: right box), 2961 were excluded, which included non‐human records (n = 527), non‐English or Chinese records (n = 505), and records of repetition (n = 1929; the first exclusion box on right side). The remaining 3266 articles were screened for abstracts. Eight full‐text articles were excluded, which included records about the history of hypertension related to the trend of oral contraceptive use (n = 3), records about menopausal hormone therapy (n = 1), records removed for the same study population (n = 2), records removed for data for prehypertension and elevated blood pressure (n = 2; the third exclusion box on right side). Thus, the number of articles included in qualitative synthesis and quantitative synthesis (meta‐analysis) was 17.Second, in the study by Chiu et al, odds ratios (ORs) and 99% confidence intervals (CIs) were provided. But, what we need were ORs and 95% CIs, so we didn't directly use the data that the original article provided. We calculated the crude ORs and 95% CIs with 4 table data by STATA version 12.0. The crude ORs (45‐58 years: 1.2, 58‐66 years: 0.9, >67 years: 0.9) were close to the ORs provided by the original article (45‐58 years: 1.1, 58‐66 years: 0.9, >67 years: 0.9).In our meta‐analyses, we evaluated the highest versus lowest category of oral contraceptive use and the risk of hypertension. So we calculated the association between >10 years oral contraceptive use and the risk of hypertension in studies by Chiu et al. As for sample size, the number of oral contraceptives user in <58 years aging group for more than 10 years is 4067, among which the proportion of patients with hypertension is 11%. Accordingly, the number of never user (<58 years) is 1411, among which the proportion of patients with hypertension is 8.9%. The total number is 5478 (n = 4067 + 1411), and the number of hypertension patients is 573 (n = 4067 × 11% + 1411 × 8.9%). The other aging groups (58‐66 years, >67 years) shared the same calculation method.Third, the basic meanings of RR, OR, and HR are similar, indicating the relationship between exposure factors and risk of disease. In general, meta‐analysis directly pooled RR, OR, and HR. Similar meta‐analysis statistical methods can also be found in study conducted by Ettehad et al.CONFLICT OF INTERESTNone declared.REFERENCESLiu H, Yao J, Wang W, et al. Association between duration of oral contraceptive use and risk of hypertension: a meta‐analysis. J Clin Hypertens (Greenwich). 2017;19:614‐614.Asgari S. Association between duration of oral contraceptive use and risk of hypertension: a meta‐analysis: methodological and Statistical Issues. J Clin Hypertens (Greenwich). 2017;19:1032‐1041.Chiu CL, Lind JM. Past oral contraceptive use and self‐reported high blood pressure in postmenopausal women. BMC Public Health. 2015;15:54.Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta‐analysis. Lancet. 2016;387:957‐967. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Hypertension Wiley

Response to: Association between duration of oral contraceptive use and risk of hypertension: A meta‐analysis: Methodological and statistical issues

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1524-6175
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Abstract

Dear Editor‐in‐Chief:We recently received the letter to the editor in response to our recently published work entitled Association between duration of oral contraceptive use and risk of hypertension: A meta‐analysis in the Journal of Clinical Hypertension. We appreciate the comments from Samaneh Asgari regarding this published paper. However, there are a few points that need to be addressed. First, of a total 6227 retrieved articles (6222: left box and 5: right box), 2961 were excluded, which included non‐human records (n = 527), non‐English or Chinese records (n = 505), and records of repetition (n = 1929; the first exclusion box on right side). The remaining 3266 articles were screened for abstracts. Eight full‐text articles were excluded, which included records about the history of hypertension related to the trend of oral contraceptive use (n = 3), records about menopausal hormone therapy (n = 1), records removed for the same study population (n = 2), records removed for data for prehypertension and elevated blood pressure (n = 2; the third exclusion box on right side). Thus, the number of articles included in qualitative synthesis and quantitative synthesis (meta‐analysis) was 17.Second, in the study by Chiu et al, odds ratios (ORs) and 99% confidence intervals (CIs) were provided. But, what we need were ORs and 95% CIs, so we didn't directly use the data that the original article provided. We calculated the crude ORs and 95% CIs with 4 table data by STATA version 12.0. The crude ORs (45‐58 years: 1.2, 58‐66 years: 0.9, >67 years: 0.9) were close to the ORs provided by the original article (45‐58 years: 1.1, 58‐66 years: 0.9, >67 years: 0.9).In our meta‐analyses, we evaluated the highest versus lowest category of oral contraceptive use and the risk of hypertension. So we calculated the association between >10 years oral contraceptive use and the risk of hypertension in studies by Chiu et al. As for sample size, the number of oral contraceptives user in <58 years aging group for more than 10 years is 4067, among which the proportion of patients with hypertension is 11%. Accordingly, the number of never user (<58 years) is 1411, among which the proportion of patients with hypertension is 8.9%. The total number is 5478 (n = 4067 + 1411), and the number of hypertension patients is 573 (n = 4067 × 11% + 1411 × 8.9%). The other aging groups (58‐66 years, >67 years) shared the same calculation method.Third, the basic meanings of RR, OR, and HR are similar, indicating the relationship between exposure factors and risk of disease. In general, meta‐analysis directly pooled RR, OR, and HR. Similar meta‐analysis statistical methods can also be found in study conducted by Ettehad et al.CONFLICT OF INTERESTNone declared.REFERENCESLiu H, Yao J, Wang W, et al. Association between duration of oral contraceptive use and risk of hypertension: a meta‐analysis. J Clin Hypertens (Greenwich). 2017;19:614‐614.Asgari S. Association between duration of oral contraceptive use and risk of hypertension: a meta‐analysis: methodological and Statistical Issues. J Clin Hypertens (Greenwich). 2017;19:1032‐1041.Chiu CL, Lind JM. Past oral contraceptive use and self‐reported high blood pressure in postmenopausal women. BMC Public Health. 2015;15:54.Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta‐analysis. Lancet. 2016;387:957‐967.

Journal

Journal of Clinical HypertensionWiley

Published: Jan 1, 2018

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