key: cord-0682559-n4k4k5ck
authors: Chiu, Tzu‐Jung; Yeh, Jiunn‐Tyng; Cheng, Hao‐Min
title: Reply to “Letter to the Editor for the Review Paper: The association between blood pressure variability with dementia and cognitive function: A systematic review and meta‐analysis”
date: 2021-08-27
journal: J Clin Hypertens (Greenwich)
DOI: 10.1111/jch.14357
sha: f168bdc5534ff974028a75f62f93476539af76d0
doc_id: 682559
cord_uid: n4k4k5ck

nan

Reply to "Letter to the Editor for the Review Paper: The association between blood pressure variability with dementia and cognitive function: A systematic review and meta-analysis"

To the Editor, we appreciate the comments from Tully and de Heus and would like to respond to their concerns. As widely recognized, systematic review and meta-analysis, due to its timely summary and analysis through comprehensive search for the best available research, is an useful research strategy to summarize the totality of evidence. 1 The a priori registration of protocols for a systematic review and metaanalysis is recommended by the reporting guideline of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

Though not mandatory, the protocol directs, yet not limits, the study of the research topic, and ensures the additive value of each metaanalysis with the latest evidence. According to the developers of the PROSPERO, protocol development is iterative and it is important to record and amend the registry during major changes in methods that may potentially result in biases. 2 During the process of this recently published systematic review and meta-analysis, 3 we found that the current literature is insufficient to answer our original research question, hence we extended the scope and conducted more subgroup analysis and dose-response meta-analysis. The limitation of our study and the necessity of conducting more clinical studies have been clearly indicated in the discussion section of our manuscript. Apart from that, we have submitted to PROSPERO an update and amendment of our protocol elaborating the changes of methods, yet due to the COVID-19 pandemic, the new version has not been publicized. We are hoping to clarify the confusion raised by the discrepancy between the yet-to-beupdated protocol and our manuscript; however, we do not think the amendment and update of the protocol should prevent the research community from receiving the timely evidence synthesis for this clin- summarizing the most up-to-date studies. Indeed, due to the scarcity of available studies, our study had limitations, which has been described in the discussion of our paper. Hence, we are pleased to see the preliminary results of the meta-analysis from the VARIABLE BRAIN consortium with a bigger effect size and more comprehensive subgroup analysis, 5 which will hopefully provide a deeper insight into the prognostic role of the blood pressure variability for incident dementia. We look forward to reading this long-awaited publication with the metaanalysis results from this esteemed consortium.

Tzu-Jung Chiu MD 1

Protocol registration issues of systematic review and meta-analysis studies: a survey of global researchers

The nuts and bolts of PROSPERO: an international prospective register of systematic reviews

Blood pressure variability and cognitive dysfunction: a systematic review and meta-analysis of longitudinal cohort studies

The association between blood pressure variability (BPV) with dementia and cognitive function: a systematic review and meta-analysis

The association of blood pressure variability with dementia and cognitive impairment: a systematic review and meta-analysis