Blood pressure

2015 ◽  
Author(s):  
Robert Fagard ◽  
Giuseppe Mancia ◽  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Elderly Women ◽  
Antihypertensive Drugs ◽  
The Elderly ◽  
Controlled Trials ◽  
Lifestyle Modifications ◽  
High Sodium ◽  
Randomized Controlled ◽  
Meta Analyses

Prevention of hypertension can help prevent cardiovascular disease and renal complications. Obesity, a high sodium and low potassium intake, physical inactivity, and high alcohol consumption all contribute to the development of hypertension, and randomized controlled trials have shown that appropriate lifestyle modifications are able to reduce blood pressure and/or prevent the development of hypertension. The major complications of hypertension are stroke, coronary heart disease, heart failure, peripheral artery disease, and chronic kidney disease. Multiple randomized controlled trials and their meta-analyses have shown that treatment with antihypertensive drugs reduces the incidence of fatal and non-fatal cardiovascular events. In addition, meta-analyses have shown that there are no clinically relevant differences in the effects of the five major drug classes on outcome, so all of them are considered suitable for the initiation and maintenance of antihypertensive therapy. Nevertheless, the therapeutic approach in the elderly, women, and patients with diabetes, cerebrovascular, cardiac, or renal disease deserves special attention.

scholarly journals Effects of popular diets on anthropometric and metabolic parameters: an umbrella review of meta-analyses of randomized controlled trials

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Monica Dinu ◽  
Giuditta Pagliai ◽  
Donato Angelino ◽  
Alice Rosi ◽  
Margherita Dall'Asta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Metabolic Risk Factors ◽  
Controlled Trials ◽  
Metabolic Risk ◽  
Umbrella Review ◽  
Anthropometric Parameters ◽  
Randomized Controlled ◽  
Meta Analyses

AbstractIntroduction:The prevalence of overweight, obesity, and their related complications is increasing worldwide. We aimed to summarise and critically evaluate the effects of different popular diets on anthropometric parameters and metabolic risk factors.Material and methods:An umbrella review of meta-analyses of randomized controlled trials was conducted according to the Joanna Briggs Institute Umbrella Review Methodology. The review protocol has been registered on PROSPERO (ID: CRD42019126103). Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, and Web of Science were searched from inception to April 2019 to identify meta-analyses of randomized controlled trials that examined the effects of different diets on anthropometric parameters and metabolic risk factors. For each association, we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval, and the 95% prediction interval. We also assessed the between-study heterogeneity and evidence for small-study effects. We further applied standardized methodological criteria to evaluate the epidemiological credibility of the statistically significant associations.Results:Overall, 80 articles reporting 495 unique meta-analyses were examined, covering a wide range of popular diets: low-carbohydrate (n = 21 articles), high-protein (n = 8), low-fat (n = 9), palaeolithic (n = 2), low glycaemic index/load (n = 12), intermittent energy restriction (n = 6), Mediterranean (n = 11), Nordic (n = 2), vegetarian (n = 9), Dietary Approaches to Stop Hypertension or DASH (n = 6), and portfolio dietary pattern (n = 1). The methodological quality of most articles (n = 65; 81%), evaluated using the AMSTAR-2 questionnaire, was low or critically low. The strength of evidence was generally weak. The most consistent evidence was reported for Mediterranean diet, with suggestive evidence of an improvement in weight, body mass index (BMI), total cholesterol, glucose and blood pressure. Suggestive evidence of an improvement in weight and blood pressure was also reported for DASH diet. Low-carbohydrate, high-protein, low-fat and low-glycaemic index/load diets showed suggestive and/or weak evidence of a reduction in weight and BMI, but contrasting evidence for lipid, glycaemic and blood pressure parameters, suggesting potential risks of unfavourable effects. Finally, evidence for palaeolithic, intermittent energy restriction, Nordic, vegetarian and portfolio dietary patterns was graded as weak or not statistically significant.Discussion:Most meta-analyses showed low methodological quality and the strength of evidence, assessed using evidence classification criteria, was generally weak. Among all the diets evaluated, Mediterranean diet had the strongest and most consistent evidence of a positive effect on both anthropometric parameters and metabolic risk factors.

scholarly journals Chinese Herbal Medicine Qi Ju Di Huang Wan for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Jie Wang ◽  
Xingjiang Xiong ◽  
Guoyan Yang ◽  
Yuqing Zhang ◽  
Yongmei Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Herbal Medicine ◽  
Randomized Controlled Trials ◽  
Chinese Herbal Medicine ◽  
Antihypertensive Drugs ◽  
Chinese Herbs ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Chinese Herbal

Background. Chinese herbs are potentially effective for hypertension. Qi Ju Di Huang Wan (QJDHW) is a commonly used Chinese herbal medicine as a monotherapy or in combination with other antihypertensive agents for the treatment of essential hypertension (EH). However, there is no critically appraised evidence such as systematic reviews or meta-analyses on the effectiveness and safety of QJDHW for EH.Methods and Findings. CENTRAL, PubMed, CBM, CNKI, VIP, and online clinical trial registry websites were searched for published and unpublished randomized controlled trials (RCTs) of QJDHW for essential hypertension up to January 2013 with no language restrictions. A total of 10 randomized trials involving 1024 patients were included. Meta-analysis showed that QJDHW combined with antihypertensive drugs was more effective in lowering blood pressure and improving TCM syndrome for the treatment of essential hypertension than antihypertensive drugs used alone. No trials reported severe adverse events related to QJDHW.Conclusions. Our review suggests that QJDHW combined with antihypertensive drugs might be an effective treatment for lowering blood pressure and improving symptoms in patients with essential hypertension. However, the finding should be interpreted with caution because of the poor methodological quality of included trials. There is an urgent need for well-designed, long-term studies to assess the effectiveness of QJDHW in the treatment of essential hypertension.

scholarly journals Almond Consumption and Risk Factors for Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (6) ◽  
pp. 1076-1088 ◽  
Author(s):  
Michelle A Lee-Bravatti ◽  
Jifan Wang ◽  
Esther E Avendano ◽  
Ligaya King ◽  
Elizabeth J Johnson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Weight ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Meta Analyses

ABSTRACT Evidence suggests that eating nuts may reduce the risk of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating almond consumption and risk factors for CVD. MEDLINE, Cochrane Central, Commonwealth Agricultural Bureau, and previous systematic reviews were searched from 1990 through June 2017 for RCTs of ≥3 wk duration that evaluated almond compared with no almond consumption in adults who were either healthy or at risk for CVD. The most appropriate stratum was selected with an almond dose closer to 42.5 g, with a control most closely matched for macronutrient composition, energy intake, and similar intervention duration. The outcomes included risk factors for CVD. Random-effects model meta-analyses and subgroup meta-analyses were performed. Fifteen eligible trials analyzed a total of 534 subjects. Almond intervention significantly decreased total cholesterol (summary net change: −10.69 mg/dL; 95% CI: −16.75, −4.63 mg/dL), LDL cholesterol (summary net change: −5.83 mg/dL; 95% CI: −9.91, −1.75 mg/dL); body weight (summary net change: −1.39 kg; 95% CI: −2.49, −0.30 kg), HDL cholesterol (summary net change: −1.26 mg/dL; 95% CI: −2.47, −0.05 mg/dL), and apolipoprotein B (apoB) (summary net change: −6.67 mg/dL; 95% CI: −12.63, −0.72 mg/dL). Triglycerides, systolic blood pressure, apolipoprotein A1, high-sensitivity C-reactive protein, and lipoprotein (a) showed no difference between almond and control in the main and subgroup analyses. Fasting blood glucose, diastolic blood pressure, and body mass index significantly decreased with almond consumption of >42.5 g compared with ≤42.5 g. Almond consumption may reduce the risk of CVD by improving blood lipids and by decreasing body weight and apoB. Substantial heterogeneity in eligible studies regarding almond interventions and dosages precludes firmer conclusions.

scholarly journals Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Xiuli Li ◽  
Peng Chang ◽  
Qiongying Wang ◽  
Hao Hu ◽  
Feng Bai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Randomized Controlled Trials ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
High Quality ◽  
Randomized Controlled ◽  
And Control

To determine the effects of ACEIs on arterial stiffness, a meta-analysis of randomized controlled trials was conducted. Relevant articles that investigated the effects of ACEIs on arterial stiffness from PubMed, Embase, and the Cochrane library from inception to September 2018 were systematically retrieved. The investigated outcomes included brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV) by using weighted mean differences (WMDs) and 95% confidence intervals (CIs) with the random-effects model. A total of 17 RCTs including 1,458 individuals were included. The summary results indicated no significant differences between ACEIs and control for ba-PWV and cf-PWV. Also, no significant differences between ACEI and control for ba-PWV and cf-PWV were observed in hypertensive patients, while the therapeutic effects of ACEI versus placebo showed statistically significant difference. Moreover, subgroup analysis indicated that the levels of ba-PWV were significantly associated if the study was conducted in Western countries, mean age <60.0 years, percentage male ≥60.0%, compared with ARBs, baseline PWV <10.0, and high-quality study. Furthermore, the significant levels of cf-PWV in patients who received ACEIs were observed when percentage male was ≥60.0% and the studies were of high-quality. Finally, no significant differences were observed between ACEIs and other antihypertensive drugs regarding the changes of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The overall analysis suggested no significant differences between ACEIs and other antihypertensive drugs for ba-PWV and cf-PWV levels, whereas ACEIs versus placebo showed lower levels of ba-PWV and cf-PWV.

scholarly journals Corn Silk Tea for Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Shihua Shi ◽  
Siming Li ◽  
Weihao Li ◽  
Hao Xu
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Antihypertensive Drugs ◽  
Current Evidence ◽  
Controlled Trials ◽  
Total Blood ◽  
Corn Silk ◽  
Randomized Controlled

Corn silk, a traditional Chinese medicine, has been found to exert an antihypertensive effect in clinical practice and trials. However, systematic review of current evidence on this topic was not available. Thus, this study aims to assess safety and efficacy of corn silk tea (CST) in improving clinical outcomes in patients with hypertension. A systematic literature search was conducted through popular electronic databases up to October 2018. Randomized controlled trials (RCTs) comparing CST plus conventional antihypertensive drugs with conventional antihypertensive drugs alone were included. The main outcome was total blood pressure lowering efficacy. The risk of bias assessment according to the Cochrane Handbook was used to evaluate the methodological quality of the included trials. Review Manager 5.3 software was used for data analyses. Five RCTs involving 567 participants were included. Due to the poor quality of methodologies of most trials, limited evidence showed that CST plus antihypertensive drugs might be more effective in lowering blood pressure compared with antihypertensive drugs alone (RR = 1.27; 95% CI: 1.17 to 1.38, P<0.00001; heterogeneity: P = 0.51, I2 = 0%, fixed‐effect model). However, there is no evidence that CST plus conventional antihypertensive drugs has less adverse events than conventional antihypertensive drugs.

scholarly journals Qiju Dihuang Decoction for Hypertension: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Shuo Zhang ◽  
Xue Bai ◽  
Zhen-Lin Chen ◽  
Jia-Jia Li ◽  
Yan-Yan Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Antihypertensive Drugs ◽  
Data Extraction ◽  
Meta Analysis ◽  
Life Quality ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Randomized Controlled

Objective. To systematically evaluate the efficacy of Chinese herbal medicine Qiju Dihuang Decoction (QDD) for hypertension. Methods. A comprehensive literature search of randomized controlled trials using QDD to treat hypertension was conducted in 7 electronic databases, including Chinese databases. Subjects and abstracts of the trials were read in NoteExpress for preliminary screening, and the full text was read for further screening. The data extraction table was made for the selected 19 trials, and risk of bias was assessed by using the Cochrane collaboration tool, followed by data analysis using Rev Man 5.3. Results. The antihypertensive efficacy of QDD is 1.45 times that of antihypertensive drugs and 1.56 times that of conventional therapies, which can also reduce the endothelin level. QPAD exhibits an antihypertensive effect, and its clinical efficacy is 1.34 times and 1.61 times that of antihypertensive drugs, which can not only significantly lower the diastolic blood pressure but also reduce the 24 h mean ambulate blood pressure. At the same time, it can decrease the TCM syndrome score, inhibit the inflammation, protect the renal function, reduce the insulin resistance, and improve the life quality of patients. Conclusion. QDD can effectively reduce blood pressure and improve the life quality of patients with hypertension, which plays a certain role in preventing hypertension complications. However, due to the methodological deficiencies, more rigorous randomized controlled trials will be needed in the future to provide stronger evidence.

scholarly journals Exercise Reduces Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Gonzalo Saco‐Ledo ◽  
Pedro L. Valenzuela ◽  
Gema Ruiz‐Hurtado ◽  
Luis M. Ruilope ◽  
Alejandro Lucia
Keyword(s):  
Blood Pressure ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Randomized Controlled Trials ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Mean

Background Although exercise training reduces office blood pressure (BP), scarcer evidence is available on whether these benefits also apply to ambulatory blood pressure (ABP), which is a stronger predictor of cardiovascular disease and mortality. The present study aims to assess the effects of exercise training on ABP in patients with hypertension based on evidence from randomized controlled trials. Methods and Results A systematic search of randomized controlled trials on the aforementioned topic was conducted in PubMed and Scopus (since inception to April 1, 2020). The mean difference between interventions (along with 95% CI) for systolic BP and diastolic BP was assessed using a random‐effects model. Sub‐analyses were performed attending to (1) whether participants were taking antihypertensive drugs and (2) exercise modalities. Fifteen studies (including 910 participants with hypertension) met the inclusion criteria. Interventions lasted 8 to 24 weeks (3–5 sessions/week). Exercise significantly reduced 24‐hour (systolic BP, −5.4 mm Hg; [95% CI, −9.2 to −1.6]; diastolic BP, −3.0 mm Hg [−5.4 to −0.6]), daytime (systolic BP, −4.5 mm Hg [−6.6 to −2.3]; diastolic BP, −3.2 mm Hg [−4.8 to −1.5]), and nighttime ABP (systolic BP, −4.7 mm Hg [−8.4 to −1.0]; diastolic BP, −3.1 mm Hg [−5.3 to −0.9]). In separate analyses, exercise benefits on all ABP measures were significant for patients taking medication (all P <0.05) but not for untreated patients (although differences between medicated and non‐medicated patients were not significant), and only aerobic exercise provided significant benefits ( P <0.05). Conclusions Aerobic exercise is an effective coadjuvant treatment for reducing ABP in medicated patients with hypertension.

Sign in / Sign up

Export Citation Format

Share Document