The application of meta-analysis in assessing racial differences in the effects of antihypertensive medication.
Meta-analysis is an important technique for synthesizing research findings. Although the statistical foundations of meta-analysis continue to be debated, few question its value as a rigorous framework for organizing literature reviews. In recent years, there has been increasing emphasis on the use of meta-analysis not only to summarize the central tendency of findings but also to explain variation between studies. This article reviews the major steps in a meta-analysis with an emphasis on comparative analysis of subgroups of studies. A meta-analysis of the antihypertensive efficacy of calcium channel blockers is used to illustrate how a comparative analysis can be applied to investigate racial variation in the effects of calcium channel blockers. A statistically significant trend is found between the proportion of African-American hypertensive subjects and the mean reduction in blood pressure. Meta-analytic techniques also are applied to explore possible confounders due to differences in research design and patient characteristics.
Messeri
P
P
Urban Health Institute, Harlem Hospital Center, New York, New York, USA.
Workman
S
S
Saunders
C
C
Francis
C
C
D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044383:Black People; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D012107:Research Design / Q000706:statistics & numerical data; D018401:Sample Size; D012737:Sex Factors; D001741:Black or African American
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers