Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials.

BACKGROUND: Insomnia is an often seen primary health care problem. Valerian might be an alternative treatment with fewer secondary effects. The aim of this study is to evaluate its effectiveness on insomnia through a meta-analysis of published literature. METHODS: Search for randomized clinical trials (RCTs) of Valerian preparations compared with a placebo on Medline, the Cochrane Library, Embase and Biosis. OUTCOMES: sleep-quality improvement (SQ, yes/no), sleep-quality improvement quantified through visual analogical scales (SQS) and the latency time (LT) in minutes until getting to sleep. Three meta-analyses were carried out using inverse-variance weighted random effects models. Heterogeneity was determined with the Q-statistic and was explored through a sub-groups analysis. Publication bias was evaluated using the funnel plot. RESULTS: Eighteen RCTs were selected; eight had a score of 5 on Jadad's scale. The mean differences in LT between the Valerian and placebo treatment groups was 0.70 min (95% CI, -3.44 to 4.83); the standardized mean differences between the groups measured with SQS was -0.02 (95% CI, -0.35 to 0.31); treatment with Valerian showed a relative risk of SQ of 1.37 (95% CI, 1.05-1.78) compared with the placebo group. There was heterogeneity in the three meta-analyses, but it diminished in the sub groups analysis. No publication bias was detected. CONCLUSION: The qualitative dichotomous results suggest that valerian would be effective for a subjective improvement of insomnia, although its effectiveness has not been demonstrated with quantitative or objective measurements. We recommend future investigations oriented toward improving insomnia with other more promising treatments.

[Follow-up and monitoring of hypertension. Is this performed the same in the autochthonous and immigrant populations?]. / Seguimiento y control de la hipertensión arterial. Se efectúa igual en la población autóctona y en la inmigrante?

OBJECTIVES: To evaluate the degree of control of blood pressure (BP) in the autochthonous and immigrant populations and to find the variables linked to good control. DESIGN: Cross-sectional, observational study. SETTING: Urban primary care team, Spain. PARTICIPANTS: All patients with hypertension seen between 1/1/2000 and 1/7/2005 and whose origin was known: 1.063 patients in all, 931 autochthonous and 132 immigrant ones. MAIN MEASUREMENTS: The main variable was hypertension control the last time BP was taken (BP

Seguimiento y control de la hipertensión arterial. ¿Se efectúa igual en la población autóctona y en la inmigrante? / Follow-up and monitoring of hypertension. Is this performed the same in the autochthonous and immigrant populations?

Objetivo. Evaluar el grado de control de la presión arterial (PA) en la población autóctona y la inmigrante y determinar las variables asociadas a un buen control. Diseño. Estudio observacional, transversal. Emplazamiento. Equipo urbano de atención primaria. Participantes. Todos los pacientes con hipertensión arterial (HTA), atendidos entre el 1 de enero de 2000 y el 1 de julio de 2005, de los que se conocía el origen: en total 1.063 pacientes, 931 autóctonos y 132 inmigrantes. Mediciones principales. La variable principal fue el control de la HTA según la última toma de PA (PA ≤ 140/90 y ≤ 130/80 en diabéticos). Además, se recogió: país de origen, edad, sexo, índice de masa corporal, factores de riesgo cardiovascular (diabetes, dislipemia, tabaquismo), exploraciones complementarias (analítica anual y electrocardiograma bienal) y fármacos prescritos. Se realizó una regresión logística para estimar el efecto del origen en el control de la PA. Resultados. Se consiguió un buen control en un 39,2% de los autóctonos y en un 25% de los inmigrantes (odds ratio [OR] = 1,6; intervalo de confianza [IC] del 95%, 1,2-2,1). No obstante, el análisis multivariable señala la edad (OR = 1,029; IC del 95%, 1,017-1,040) como único factor asociado al buen control de la PA. Conclusiones. El origen del paciente no influye en el control de la PA

Objectives. To evaluate the degree of control of blood pressure (BP) in the autochthonous and immigrant populations and to find the variables linked to good control. Design. Cross-sectional, observational study. Setting. Urban primary care team, Spain. Participants. All patients with hypertension seen between 1/1/2000 and 1/7/2005 and whose origin was known: 1.063 patients in all, 931 autochthonous and 132 immigrant ones. Main measurements. The main variable was hypertension control the last time BP was taken (BP ≤140/90 mm Hg and ≤130/80 mm Hg in diabetics). In addition, data on country of origin, age, gender, body mass index, cardiovascular risk factors (diabetes, lipaemia, tobacco dependency), further examinations (annual blood analysis and ECG every 2 years) and prescribed medication were recorded. Logistic regression was used to calculate the effect of origin on blood pressure monitoring. Results. Good BP control was achieved in 39.2% of autochthonous patients and 25% of immigrants (odds ratio [OR], 1.6; 95% confidence interval [CI], 95% CI, 1.2-2.1). Nevertheless, multivariate analysis indicated age (OR, 1.029; 95% CI, 1.017-1.040) as the sole factor determining good or bad BP control. Conclusions. The origin of the patient does not affect BP control