SYSTOLIC AND DIASTOLIC BLOOD PRESSURE AND THEIR INTERACTION AFTER MYOCARDIAL INFARCTION AND LONG TERM MORTALITY

Results: Of 831 screened studies, we reviewed 43 studies (10320 participants, 17.5% Asians, 82.4% Whites, 0.1%Blacks). Across 38 studies, both DD homozygotes (n1⁄4 2440) and DI heterozygotes (n1⁄4 4310) had higher (p 0.002) LVM or LVM index than II homozygotes (n1⁄4 2229). Across 21 studies with available data, this was due to increased mean wall thickness (MWT) with no difference in left ventricular internal diameter (LVID). Standardised differences (DD vs II) were 0.39 (95% confidence interval 0.20 to 0.59, p< 0.001) for LVM, 0.34 (0.085 to 0.59, p1⁄4 0.009) for MWT, and 0.066 (–0.049 to 0.18; p1⁄4 0.26) for LVID. Across 16 studies (4894 participants), the pooled odds ratios of LVH (vs II homozygotes) were 1.11 (0.91 to 1.36, p1⁄4 0.29) and 1.02 (CI 0.75 to 1.39, p1⁄4 0.88) for the DD and DI genotypes, respectively. For LVM, there was a deficit of small studies with null results, but for LVH we did not find publication bias. Sensitivity analyses were confirmatory.