Aim: Sleep duration has been suggested to be associated with hypertension (HTN). However, evidence of the nature of the relationship and its direction has been inconsistent. Therefore, we performed a meta-analysis to assess the relationship between sleep duration and risk of HTN incidence, and to distinguish more susceptible populations. Methods: PubMed, Embase, Scopus, Web of Science, and ProQuest were searched from January 2000 to May 2023 for cohort studies comparing short and long sleep durations with 7–8 hours of sleep for the risk of HTN incidence. Random-effect model (the DerSimonian-Laird method) was applied to pool risk ratios (RR) and 95% confidence interval (CI). Results: We included sixteen studies ranging from 2.4 to 18 years of follow-up duration evaluating HTN incidence in 1,044,035 people. Short sleep duration was significantly associated with a higher risk of developing HTN (HR: 1.07, 95% CI: 1.06–1.09). The association was stronger when the sleep duration was less than 5 hours (HR: 1.11, 95% CI: 1.08–1.14). In contrast to males, females (HR: 1.07, 95% CI: 1.04–1.09) were more vulnerable to developing HTN due to short sleep duration. No significant difference between different follow-up durations and age subgroups was observed. Long sleep duration was not associated with an increased incidence of HTN. Conclusion: Short sleep duration was associated with higher risk of HTN incidence, however, there was no association between long sleep duration and incidence of HTN. These findings highlight the importance of implementing target-specific preventive and interventional strategies for vulnerable populations with short sleep duration to reduce the risk of HTN.

Background: It remains controversial whether adding ezetimibe to low/moderate‐intensity statins has a more beneficial impact on the treatment efficacy and safety of patients with existing atherosclerotic cardiovascular disease (ASCVD) compared to high‐intensity statin regimens.Hypothesis: A combination of low/moderate‐intensity statins plus ezetimibe might be more effective and safer than high‐intensity statin monotherapy.Methods: We searched databases for randomized controlled trials comparing lipid profile alterations, drug‐related adverse events, and MACE components between high‐intensity statin monotherapy and low/moderate‐intensity statin plus ezetimibe combination therapy. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) were estimated using a random‐effects model.Results: Our comprehensive search resulted in 32 studies comprising 6162 patients treated with monotherapy against 5880 patients on combination therapy. Combination therapy was more effective in reducing low‐density lipoprotein cholesterol (LDL‐C) levels compared to monotherapy (MD = −6.6, 95% CI: −10.6 to −2.5); however, no significant differences were observed in other lipid parameters. Furthermore, the combination therapy group experienced a lower risk of myalgia (RR = 0.27, 95% CI: 0.13–0.57) and discontinuation due to adverse events (RR = 0.61, 95% CI: 0.51–0.74). The occurrence of MACE was similar between the two treatment groups.Conclusions: Adding ezetimibe to low/moderate‐intensity statins resulted in a greater reduction in LDL‐C levels, a lower rate of myalgia, and less drug discontinuation compared to high‐intensity statin monotherapy in patients with existing cardiovascular disease. However, according to our meta‐analysis, the observed reduction in LDL‐C levels in the combination group did not correlate with a reduction in MACE compared to the high‐intensity statin group.

Background: High-intensity statin therapy is currently recommended initial guideline therapy in ACS treatment. However, only a minority of patients are achieving LDL-C attainment goal at 6 months. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are on recommended guideline therapy post-ACS if LDL-C goal attainment is not achieved after high-intensity statin (4–6 weeks) and after the addition of ezetimibe if guideline goal attainment is not achieved after an additional 4–6 weeks. Thus, it has been recommended that PCSK9 inhibitors be considered earlier post-ACS. However, the efficacy of early PCSK9 inhibitors initiation in ACS patients remains uncertain. Methods: This systematic review and meta-analysis was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) and observational studies involving ACS patients who received PCSK9 inhibitors within 48 h of hospitalization were included. Common and random effects models were used to evaluate the pooled effect of early PCSK9 inhibitor administration. Nine RCTs and three cohort studies were included. Results: Early PCSK9 inhibitor administration reduced the incidence of MI, ACS hospitalization, and revascularization at 6–18 months post-ACS. Although there was a drift towards reduced stroke, all-cause mortality, and cardiovascular death, no statistically significant reduction was observed. Additionally, PCSK9 inhibitors significantly enhanced lipid control at 4–12 weeks after index hospitalization. Conclusion: Early PCSK9 inhibitors initiation in ACS patients reduces MACE and improves lipid profiles. While the results propose promising benefits in terms of stroke and mortality, further research with longer follow-up is required for more decisive evidence.

By 2025, global obesity rates are projected to reach 16% in men and 21% in women, imposing a significant public health burden. Obesity is a major contributor to hypertension (HTN), exacerbating cardiovascular risks. This review and meta-analysis evaluated the effectiveness of non-surgical treatments versus bariatric surgery in managing hypertension among obese individuals. We searched PubMed, Scopus, Embase, and Cochrane databases up to May 2024. Randomized controlled trials (RCTs) comparing bariatric surgery (e.g., Roux-en-Y Gastric Bypass (RYGB), Sleeve gastrectomy (SG), Laparoscopic adjustable gastric banding (LAGB), Duodenal-jejunal bypass liner/Biliopancreatic diversion (DJBL/BPD)) with non-surgical interventions (e.g., lifestyle modifications, medications) in hypertensive obese patients were included. Primary outcomes were changes in systolic and diastolic blood pressure. Secondary outcomes included changes in fasting blood sugar (FBS), HbA1c, and lipid profiles. Data were synthesized using a random-effects model, with heterogeneity and publication bias assessed. From 7,187 records, 29 studies involving 2,548 patients met the inclusion criteria. Bariatric surgery resulted in greater reductions in systolic (MD: -4.506 mmHg; 95% CI: -6.999 to -2.013) and diastolic (MD: -3.040 mmHg; 95% CI: -4.765 to -1.314) blood pressure compared to non-surgical interventions. Roux-en-Y gastric bypass had the most significant impact. Bariatric surgery also led to substantial reductions in FBS (MD: -30.444 mg/dl; 95% CI: -41.288 to -19.601), HbA1c (MD: -1.108%; 95% CI: -1.414 to -0.802), and triglycerides (MD: -39.746 mg/dl; 95% CI: -54.458 to -25.034), and increased HDL levels (MD: 7.387 mg/dl; 95% CI: 5.056 to 9.719). The quality of evidence was high for most outcomes, supporting these findings. Bariatric surgery is superior to non-surgical treatments in managing obesity-related hypertension and metabolic disorders. Reductions in blood pressure, glycemic indexes, and lipid profiles highlight bariatric surgery’s critical role in improving cardiovascular health and metabolic outcomes in obese hypertensive patients.

Background: Transcatheter aortic valve implantation (TAVI) has been increasingly used in patients with severe aortic stenosis (AS). Since coronary artery disease (CAD) is common among these patients, it is crucial to choose the best method and timing of revascularization. This study aims to compare different timing strategies of percutaneous coronary intervention (PCI) in patients with severe AS undergoing TAVI to clarify whether PCI timing affects the patients' outcomes or not.Methods: A frequentist network meta‐analysis was conducted comparing three different revascularization strategies in patients with CAD undergoing TAVI. The 30‐day all‐cause mortality, in‐hospital mortality, all‐cause mortality at 1 year, 30‐day rates of myocardial infarction (MI), stroke, and major bleeding, and the need for pacemaker implantation at 6 months were analyzed in this study.Results: Our meta‐analysis revealed that PCI during TAVI had higher 30‐day mortality (RR = 2.46, 95% CI = 1.40–4.32) and in‐hospital mortality (RR = 1.70, 95% CI = [1.08–2.69]) compared to no PCI. Post‐TAVI PCI was associated with higher 1‐year mortality compared to other strategies. While no significant differences in major bleeding or stroke were observed, PCI during TAVI versus no PCI (RR = 3.63, 95% CI = 1.27–10.43) showed a higher rate of 30‐day MI.Conclusion: Our findings suggest that among patients with severe AS and CAD undergoing TAVI, PCI concomitantly with TAVI seems to be associated with worse 30‐day outcomes compared with no PCI. PCI after TAVI demonstrated an increased risk of 1‐year mortality compared to alternative strategies. Choosing a timing strategy should be individualized based on patient characteristics and procedural considerations.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM), with insulin resistance (IR) increasingly recognized as a key contributor. The estimated glucose disposal rate (eGDR), a surrogate marker of insulin sensitivity, has been proposed as a predictor of adverse cardiovascular outcomes in T1DM. This systematic review and meta-analysis aimed to assess the association between eGDR and adverse cardiovascular outcomes. A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted through March 6, 2025, to identify studies reporting multivariable-adjusted risk estimates linking eGDR with cardiovascular outcomes in individuals with T1DM. Pooled hazard ratios (HRs) were estimated using random-effects models with the Paule–Mandel method and Knapp–Hartung adjustment. Subgroup and meta-regression analyses were conducted to explore potential effect modifiers, and leave-one-out (LOO) sensitivity analyses were performed to assess the robustness of findings. Sixteen studies comprising 29,075 individuals with T1DM were included. Higher eGDR was significantly associated with lower risk of MACE and all-cause mortality, with hazard ratios per unit increase of 0.79 (95% CI: 0.72–0.87; I² = 63%) and 0.84 (95% CI: 0.82–0.86; I² = 0%), respectively. Lower eGDR was also associated with increased risk of CAD (low vs. high eGDR: HR 3.61; 95% CI: 2.83–4.62; I² = 0%). Subgroup analyses suggested a stronger protective association between eGDR and MACE among older individuals (≥ 40 years), those with BMI < 25 kg/m², and those with longer diabetes duration (≥ 20 years). LOO sensitivity analyses showed that CAD was the only outcome influenced by exclusion of the largest study. Lower eGDR is consistently associated with increased risk of MACE, CAD, and all-cause mortality in individuals with T1DM. These findings support the utility of eGDR as a practical, non-invasive marker for cardiovascular risk stratification in this high-risk population.