Outcome standardization to blood pressure reduction in meta-analyses: sailing in uncharted waters

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In the current issue of the Journal of Hypertension, Brunström and Carlberg [1] question the role of standardization procedure to report the results of meta-analyses in the field of hypertension. Authors are dealing with an important and at the same time intriguing issue, as the standardization to blood pressure (BP) reduction of relative risks (RRs) with or without their standard errors (SEs) may introduce bias in the interpretation of the results. It is important, as the pooled risk estimates after standardization are different from those based on crude estimates, and it is intriguing, because various standardization methodologies have been used previously by different groups of investigators to report their findings [2–4]. However, other investigators including the authors of the present meta-analysis [1] constantly have resisted standardizing to BP reduction [5], whereas others have selected to standardize or not based on the research question [6].

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