Effects of pistachios on anthropometric indices, inflammatory markers, endothelial function, and blood pressure in adults: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 1-27
Author(s):  
Omid Asbaghi ◽  
Amir Hadi ◽  
Marilyn S. Campbell ◽  
Kamesh Venkatakrishnan ◽  
Ehsan Ghaedi

Abstract Evidence suggests that eating nuts may reduce the risk of cardiovascular disease (CVD). This study was intended to pool the data of all randomized controlled trials (RCTs) available to determine if pistachios confer a beneficial effect on anthropometric indices, inflammatory markers, endothelial dysfunction, and blood pressure. Without language restriction, PubMed, Scopus, Cochrane Library and Web of Science were searched for articles published from the earliest records to June 2019 investigating the effect of pistachio consumption on inflammation, endothelial dysfunction, and hypertension. Mean difference (MD) was pooled using a random-effects model. The Cochrane Risk of Bias tool was used to evaluate the quality of the studies. The meta-analysis of 13 RCTs with 563 participants indicated that pistachio consumption significantly decreased systolic blood pressure (SBP) (MD: -2.12 mmHg, 95% CI: -3.65 to -0.59, p=0.007), whereas changes in flow-mediated dilation (MD: 0.94 %, 95% CI: -0.99 to 2.86, p=0.813), diastolic blood pressure (MD: 0.32 mmHg, 95% CI: -1.37 to 2.02, p=0.707), C-reactive protein (MD: 0.00 mg/l, 95% CI: -0.21 to 0.23, p=0.942), tumor necrosis factor alpha (MD: -0.09 pg/ml, 95% CI: -0.38 to 0.20, p=0.541), body weight (MD: 0.09 kg, 95% CI: -0.38 to 0.69, p=0.697), body mass index (MD: 0.07 kg/m2, 95% CI: -0.16 to 0.31, p=0.553) and waist circumference (MD: 0.77 cm, 95% CI: -0.09 to 1.64, p=0.140) were not statistically significant. This systematic review and meta-analysis suggested the efficacy of pistachio consumption to reduce SBP levels. However, further large-scale studies are needed to confirm these results.

2019 ◽  
Vol 51 (03) ◽  
pp. 157-164 ◽  
Author(s):  
Amir Hadi ◽  
Ehsan Ghaedi ◽  
Sajjad Moradi ◽  
Makan Pourmasoumi ◽  
Abed Ghavami ◽  
...  

AbstractMelatonin is a physiological indoleamine secreted from the pineal gland into the bloodstream. This hormone has antioxidant effects in cardiovascular disease, but the evidence regarding its effects on blood pressure (BP) has not been conclusive. Therefore, we assessed the impact of melatonin supplementation on systolic BP (SBP) and diastolic BP (DBP) through a systematic review and meta—analysis of available randomized controlled trials (RCTs). Medline, Scopus, Web of Science, Cochrane library, and Google scholar (until May 2018) were searched to identify potential RCTs with information on melatonin supplementation and BP. Mean Differences (MD) were pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias. Pooling 5 RCTs (6 treatment arms) together identified significant reduction for SBP (MD: −3.43 mmHg, 95% confidence interval (CI): −5.76 to −1.09, p=0.004) and DBP (MD: −3.33 mmHg, 95% CI: −4.57 to −2.08, p<0.001) after supplementation with melatonin compared with control treatment. The sensitivity analysis indicated that the results were robust. We did not observe any evidence regarding publication bias. The findings of this meta-analysis support the overall favorable effect of melatonin supplementation on BP regulation.


10.2196/24116 ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. e24116
Author(s):  
Meina Lv ◽  
Tingting Wu ◽  
Shaojun Jiang ◽  
Wenjun Chen ◽  
Jinhua Zhang

Background Stroke is a common, harmful disease with high recurrence and mortality rates. Uncontrolled blood pressure is an important and changeable risk factor for stroke recurrence. Telemedicine and mobile health (mHealth) interventions may have the potential to facilitate the control of blood pressure among stroke survivors, but their effect has not been established. Objective This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to estimate the effects of telemedicine and mHealth interventions on the control of systolic blood pressure among stroke survivors. Methods The research literature published up to June 28, 2020, and consisting of RCTs related to telemedicine and mHealth interventions was searched in PubMed, EMBASE, Web of Science, and the Cochrane Library. The Cochrane risk of bias tool (RoB 2.0) was used to evaluate the quality of the studies. The Cochran Q test and I2 statistic were used to assess heterogeneity. Data were meta-analyzed using a random-effects model. Mean difference (MD) with 95% CI and 95% prediction interval (PI) were calculated. Results In total, 9 RCTs with a total sample size of 1583 stroke survivors met the inclusion criteria. Compared with the usual care, telemedicine and mHealth had a significantly greater impact on the control of systolic blood pressure (MD –5.49; 95% CI –7.87 to –3.10; P<.001; 95% PI –10.46 to –0.51). A subgroup analysis showed that the intervention mode of telephone plus SMS text messaging (MD –9.09; 95% CI –12.71 to –5.46; P<.001) or only telephone (MD –4.34; 95% CI –6.55 to –2.13; P<.001; 95% PI –7.24 to –1.45) had a greater impact on the control of systolic blood pressure than usual care. Among the stroke survivors with an intervention interval ≤1 week (MD –6.51; 95% CI –9.36 to –3.66; P<.001; 95% PI –12.91 to –0.10) or a baseline systolic blood pressure ≥140 mm Hg (MD –6.15; 95% CI –9.44 to –2.86; P<.001; 95% PI –13.55 to 1.26), the control of systolic blood pressure using telemedicine and mHealth was better than that of usual care. Conclusions In general, telemedicine and mHealth reduced the systolic blood pressure of stroke survivors by an average of 5.49 mm Hg compared with usual care. Telemedicine and mHealth are a relatively new intervention mode with potential applications for the control of systolic blood pressure among stroke survivors, especially those with hypertensive stroke.


2020 ◽  
Author(s):  
Meina Lv ◽  
Tingting Wu ◽  
Shaojun Jiang ◽  
Wenjun Chen ◽  
Jinhua Zhang

BACKGROUND Stroke is a common, harmful disease with high recurrence and mortality rates. Uncontrolled blood pressure is an important and changeable risk factor for stroke recurrence. Telemedicine and mobile health (mHealth) interventions may have the potential to facilitate the control of blood pressure among stroke survivors, but their effect has not been established. OBJECTIVE This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to estimate the effects of telemedicine and mHealth interventions on the control of systolic blood pressure among stroke survivors. METHODS The research literature published up to June 28, 2020, and consisting of RCTs related to telemedicine and mHealth interventions was searched in PubMed, EMBASE, Web of Science, and the Cochrane Library. The Cochrane risk of bias tool (RoB 2.0) was used to evaluate the quality of the studies. The Cochran <i>Q</i> test and <i>I</i><sup>2</sup> statistic were used to assess heterogeneity. Data were meta-analyzed using a random-effects model. Mean difference (MD) with 95% CI and 95% prediction interval (PI) were calculated. RESULTS In total, 9 RCTs with a total sample size of 1583 stroke survivors met the inclusion criteria. Compared with the usual care, telemedicine and mHealth had a significantly greater impact on the control of systolic blood pressure (MD –5.49; 95% CI –7.87 to –3.10; <i>P</i>&lt;.001; 95% PI –10.46 to –0.51). A subgroup analysis showed that the intervention mode of telephone plus SMS text messaging (MD –9.09; 95% CI –12.71 to –5.46; <i>P</i>&lt;.001) or only telephone (MD –4.34; 95% CI –6.55 to –2.13; <i>P</i>&lt;.001; 95% PI –7.24 to –1.45) had a greater impact on the control of systolic blood pressure than usual care. Among the stroke survivors with an intervention interval ≤1 week (MD –6.51; 95% CI –9.36 to –3.66; <i>P</i>&lt;.001; 95% PI –12.91 to –0.10) or a baseline systolic blood pressure ≥140 mm Hg (MD –6.15; 95% CI –9.44 to –2.86; <i>P</i>&lt;.001; 95% PI –13.55 to 1.26), the control of systolic blood pressure using telemedicine and mHealth was better than that of usual care. CONCLUSIONS In general, telemedicine and mHealth reduced the systolic blood pressure of stroke survivors by an average of 5.49 mm Hg compared with usual care. Telemedicine and mHealth are a relatively new intervention mode with potential applications for the control of systolic blood pressure among stroke survivors, especially those with hypertensive stroke. CLINICALTRIAL


Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.


2021 ◽  
Vol 24 (1) ◽  
pp. 627-645
Author(s):  
Omid Asbaghi ◽  
Fatemeh Naeini ◽  
Vihan Moodi ◽  
Moein Najafi ◽  
Mina Shirinbakhshmasoleh ◽  
...  

2017 ◽  
Vol 105 (5) ◽  
pp. 1176-1190 ◽  
Author(s):  
Charlotte EL Evans ◽  
Darren C Greenwood ◽  
Diane E Threapleton ◽  
Chris P Gale ◽  
Christine L Cleghorn ◽  
...  

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