Characteristics of Asian patients with Fibromuscular Dysplasia: a systematic review and meta-analysis

A significant knowledge gap exists regarding characteristics of fibromuscular dysplasia (FMD) in Asian patients compared to Caucasian populations. This meta-analysis evaluated FMD characteristics in Asia (PROSPERO ID: CRD42024596516). PubMed, EMBASE, Cochrane Library, Web of Science, VIP, CNKI, and Wanfang databases were searched for observational studies after January 1, 2000, focusing on FMD in Asian populations. Twenty-four studies including 1254 Asian participants (1059 Chinese, 134 Japanese, and 61 others) were analyzed. Among Asian FMD patients, 59.0% (95% CI: 54.3-63.5%) were women, and mean age at FMD diagnosis was 28.6 years (26.7-30.6 years). Multifocal FMD was diagnosed in 38.4% (28.5-48.8%) of participants, and multivessel FMD in 12.7% (4.6-23.6%). Aneurysms and dissections were reported in 13.5% (7.8-20.4%) and 9.0% (1.8-19.9%) of participants, respectively. 99.9% (98.6-100.0%) of patients were hypertensive, 7.6% (5.3-10.2%) had a history of stroke and 40.3% (22.2-59.8%) reported headache. Bilateral renal artery involvement was documented in 17.9% (13.5-22.6%) of participants, and renal atrophy in 29.9% (24.4-35.6%). Compared with Japanese patients, Chinese patients were younger (26.2 vs. 36.2 years, P < 0.001). Furthermore, the proportion of women (59.4% vs. 64.3%, P = 0.334), and multifocal FMD (33.4% vs. 51.6%, P = 0.085) tended to be lower in Chinese versus Japanese patients. In conclusion, compared to published data in Caucasian patients, Asian FMD patients were younger, more often men, with focal FMD, and had lower rates of multivessel involvement, aneurysms, and dissections. Similar trends were found both in Chinese and Japanese patients. Our meta-analysis showed that compared to published data in Caucasian patients, Asian patients with FMD were younger, more often men, with focal FMD, and had lower rates of multivessel involvement, aneurysms, and dissections. Similar trends were found both in Chinese and Japanese patients.