Prevention & lipidsMeta-analysis
Under-representation of ethnic and regional minorities in lipid-lowering randomized clinical trials: a systematic review and meta-analysis
- Systematic review and meta-analysis of randomised trials
- random-effects
Authors' conclusion
Despite under-representation in clinical trials, regional and ethnic minority groups such as Australasia and Blacks appear to derive at least as much cardiovascular benefit from LLT.
Study context
- Population
- Participants in randomized clinical trials (RCTs) of lipid-lowering therapies, by region and ethnicity
- Participants
- 329,897 participants · 53 trials
- Comparison
- Intensive vs less-intensive low-density lipoprotein cholesterol (LDL-C) lowering, by ethnicity and region
- Outcome
- MACE:
- CV mortality
- MI
- Stroke
- Revascularization
Pooled result
As reported in the abstract
MACE per mmol/L LDL-C reduction with lipid-lowering therapies (LLT), by region and ethnicity (subgroups)
- Australasia: RR
- 0.75 (0.67-0.85) (95% CI)
- North America: RR
- 0.75 (0.69-0.83) (95% CI)
- Europe: RR
- 0.78 (0.71-0.86) (95% CI)
- Japan: RR
- 0.73 (0.63-0.85) (95% CI)
- Black ethnicity: RR
- 0.55 (0.37-0.82) (95% CI)
Further pooled results
Representation of participants by region
- Europe
- 39.5%
- North America
- 16.0%
- Japan
- 9.0%
- Australasia
- 2.8%
- South America
- 1.8%
- Asia
- 1.1%
- South Africa
- 0.6%
- Unspecified
- 29.2%
Representation by ethnicity (trials reporting ethnicities)
- White
- 60.3%
- Japanese
- 20.2%
- Asian
- 9.4%
- Black
- 5.5%
- Latin American
- 4.7%
Original publication
Under-representation of ethnic and regional minorities in lipid-lowering randomized clinical trials: a systematic review and meta-analysis. Eur J Prev Cardiol. Published 7 February 2023. doi:10.1093/eurjpc/zwad030
Summarised from the published abstract; every number is checked against it