scholarly journals Effects of Three Traditional Chinese Fitness Exercises Combined with Antihypertensive Drugs on Patients with Essential Hypertension: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Lulu Dai ◽  
Yuerong Jiang ◽  
Peili Wang ◽  
Keji Chen
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Randomized Controlled Trials ◽  
Tai Chi ◽  
Assessment Tool ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Therapeutic Benefit ◽  
Controlled Trials ◽  
Randomized Controlled

Objective. To compare the efficacy of three different traditional Chinese exercises (Tai Chi, Baduanjin, and Wuqinxi) combined with antihypertensive drugs (AHD) on patients with essential hypertension (EH). Method. Eight electronic databases were searched to identify randomized controlled trials (RCTs) comparing the effects of traditional Chinese fitness exercises combined with AHD and AHD alone. The analysis mainly consists of network meta-analysis (NMA) and pairwise meta-analysis. The Cochrane assessment tool was adopted to assess the risk of bias of included literatures. This study used STATA/SE 15.1 (StataCorp, 2017), R software (version 4.0.1), and Cochrane’s Review Manager software (version 5.4) to conduct data analysis and figures generation. Results. A total of 30 RCTs were included in this study, of which 16 evaluated Tai Chi plus AHD versus AHD, 11 evaluated Baduanjin plus AHD versus AHD, and 3 evaluated Wuqinxi plus AHD versus AHD. No RCT compared directly among the three traditional Chinese fitness exercises. Pairwise meta-analysis showed that Tai Chi plus AHD was significantly superior to AHD alone in reducing systolic blood pressure (SBP) and diastolic blood pressure (DBP). BDJ plus AHD was statistically superior to AHD alone in reducing SBP, DBP, and endothelin (ET) and increasing nitric oxide (NO). NMA results indicated that Tai Chi plus AHD (WMD −12.42 mmHg, 95% CI: −15.29 to −9.55) and Baduanjin plus AHD (WMD −7.03 mmHg, 95% CI: −9.80 to −4.26) were superior to AHD, and Tai Chi was more effective than other traditional exercises in lowering SBP, Tai Chi plus AHD (WMD −7.56 mmHg, 95% CI: −10.15 to −4.96) and Baduanjin plus AHD (WMD −4.51 mmHg, 95% CI: −7.38 to −1.65) were superior to AHD in reducing DBP, Baduanjin plus AHD (WMD 4.26 μmol/L, 95%CI: 2.68 to 5.83) was statistically superior to AHD in increasing NO, and Tai Chi plus AHD (WMD −7.64 pg/ml, 95% CI: −10.46 to −4.83) and Baduanjin plus AHD (WMD −9.23 pg/ml, 95% CI: −10.85 to −7.61) were superior to AHD in lowering ET. Conclusion. Compared with AHD alone, both Tai Chi plus AHD and Baduanjin plus AHD showed significant benefit in regulating SBP, DBP, and ET. Among the three traditional Chinese fitness exercises, Tai Chi may be the best as an adjunctive therapy for SBP reduction. These findings provided evidence for the therapeutic benefit of either Tai Chi or Baduanjin exercise as an adjunct therapy for patients with EH. Limited by the methodological quality and quantity of included studies, results need to be interpreted with caution, and it is necessary to carry out further high-quality RCTs on traditional Chinese fitness exercise-assisted treatment of EH in the future.

scholarly journals Zhen Gan Xi Feng Decoction, a Traditional Chinese Herbal Formula, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Xingjiang Xiong ◽  
Xiaochen Yang ◽  
Bo Feng ◽  
Wei Liu ◽  
Lian Duan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Randomized Controlled Trials ◽  
Methodological Quality ◽  
Antihypertensive Drugs ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Controlled Trials ◽  
Randomized Controlled

Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH).Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP).Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain.Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.

scholarly journals The Efficacy of Tai Chi and Qigong Exercises on Blood Pressure and Blood Levels of Nitric Oxide and Endothelin-1 in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-24
Author(s):  
Dingcheng Liu ◽  
Lan Yi ◽  
Meixiao Sheng ◽  
Gang Wang ◽  
Yanqin Zou
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Randomized Controlled Trials ◽  
Tai Chi ◽  
Meta Analysis ◽  
Blood Levels ◽  
Controlled Trials ◽  
Endothelin 1 ◽  
Randomized Controlled

Objective. Tai Chi and Qigong are the two similar traditional Chinese wellness exercises. A strong body of published clinical randomized controlled trials (RCTs) has investigated the health benefits of Tai Chi and Qigong exercises (TCQE) in patients with essential hypertension (EH). This is the first meta-analysis to evaluate the efficacy of TCQE on blood pressure (BP) and blood levels of nitric oxide (NO) and endothelin-1 (ET-1) in EH patients and explore the potential antihypertensive mechanism of TCQE. Methods. We conducted a literature retrieval for Chinese and English studies in seven databases from their respective inceptions until January 14, 2020. All RCTs examining clinical efficacy of TCQE for EH patients were considered. The major therapeutic outcomes of TCQE were changes in the blood levels of NO, ET-1, and BP in EH patients. Methodological quality of the included RCTs was detected via The Cochrane Risk of Bias tool. We evaluated the data reported and performed the meta-analysis by Review Manager 5.3 software. Results. 9 RCTs involving 516 EH patients were included. The intervention duration lasted from 1.5 months to 6 months. The results of comprehensive analysis showed that compared with control interventions, experimental interventions were more effective in reducing the systolic blood pressure and the diastolic blood pressure and contributed higher blood levels of NO and lower blood levels of ET-1. Conclusions. TCQE could be an effective complementary and alternative therapy for EH. The lower BP in EH patients who practice TCQE may have some connection with exercise-related increased blood NO levels and decreased blood ET-1 levels. However, further research is needed to make clear the efficacy of TCQE in management of EH and the mechanism of lowering BP in TCQE.

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 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 Tai Chi as a Therapy of Traditional Chinese Medicine on Reducing Blood Pressure: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Xiandu Pan ◽  
Li Tian ◽  
Fan Yang ◽  
Jiahao Sun ◽  
Xinye Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Tai Chi ◽  
Meta Analysis ◽  
Bodily Pain ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Tai Chi Exercise

Objective. This study systematically evaluated the effects of Tai Chi exercise on blood pressure, body mass index (BMI), and quality of life (QOL) in patients with hypertension. A meta-analysis was performed to provide a reliable reference for clinical practice. Methods. We searched for randomized controlled trials (RCTs) in five English databases and two Chinese databases, with the earliest data dated December 5, 2020. A quality assessment of the methods and a meta-analysis were also conducted. Results. The meta-analysis of 24 studies showed that the intervention group showed better outcomes in terms of systolic blood pressure (SBP) (SMD −1.05, 95% CI −1.44 to −0.67, P ≤ 0.001 ; I2 = 93.7%), diastolic blood pressure (DBP) (SMD −0.91, 95% CI −1.24 to −0.58, P ≤ 0.001 ; I2 = 91.9%), and QOL (physical functioning (SMD 0.86, 95% CI 0.36 to 1.37, P = 0.001 ; I2 = 91.3%), role-physical (SMD 0.86, 95% CI 0.61 to 1.11, P ≤ 0.001 ; I2 = 65%), general health (SMD 0.75, 95% CI 0.32 to 1.17, P = 0.001 ; I2 = 88.1%), bodily pain (SMD 0.65, 95% CI 0.29 to 1.00, P ≤ 0.001 ; I2 = 83.1%), vitality (SMD 0.71, 95% CI 0.34 to 1.07, P ≤ 0.001 ; I2 = 84.3%), social functioning (SMD 0.63, 95% CI 0.07 to 1.19, P = 0.027 ; I2 = 93.1%), role-emotional (SMD 0.64, 95% CI 0.22 to 1.06, P = 0.003 ; I2 = 88.1%), and mental health (SMD 0.73, 95% CI 0.31 to 1.16, P = 0.001 ; I2 = 88.2%)) compared to those of the control group. However, no significant improvements were seen in BMI of the intervention group (SMD −0.08, 95% CI −0.35 to −0.19, P = 0.554 ; I2 = 69.4%) compared to that of the control group. Conclusion. Tai Chi is an effective intervention to improve SBP and DBP in patients with essential hypertension.

Abstract 17683: LCZ696 vs. ACEI/ARB for Hypertension: A Meta-analysis of Randomized Controlled Trials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Abdulah Alrifai ◽  
shadi Al Halabi ◽  
Robert Chait
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Ii ◽  
Systolic Blood Pressure ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Angiotensin Ii Receptor ◽  
Randomized Controlled

Introduction: LCZ696 is a first-in-class inhibitor of the angiotensin II receptor and Neprilysin. The use of LCZ696 in Heart Failure is promising compared to ACEI or ARB. The use of LCZ696 for blood pressure has been studied but controversial. We performed a meta-analysis of randomized controlled trials (RCTs) comparing LCZ696 to ACEI/ARB for lowering systolic blood pressure effect. Objectives: To assess the efficacy of LCZ696 on systolic blood pressure in comparison to angiotensin-converting-enzyme inhibitor (ACEI)/Angiotensin II receptor antagonist (ARB). Methods: We searched PubMed, Medline, Embase and Cochrane for prospective RCTs that compared LCZ696 versus ACEI or ARB in patients with established diagnosis of essential hypertension. Trials that included patients with essential hypertension with or without heart failure were randomized to either LCZ696 or ACEI or ARB, and that also reported at least one of the studied outcomes were included. Study quality was assessed using the Jadad score. Heterogeneity of the studies was analyzed by Cochran’s Q statistics. Mean differences were calculated using the random effect model. Results: Three RCTs met our inclusion criteria and included 8996 patients who had mild-moderate essential hypertension and were between18-75 years. They were randomized to LCZ696 versus ACEI or ARB. The use of LCZ696 was associated with improved systolic blood pressure control when compared to the control group (MD -3.89; 95% CI -7.75, -0.04; P=0.05). Conclusions: Our findings suggest that the use of LCZ696 in hypertensive patients provides better reduction of blood pressure when compared to an ACEI or an ARB.

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 Meta-Analysis of Randomized Controlled Trials of the Effects of Tai Chi on Blood Pressure

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Xiaosheng Dong ◽  
Meng Ding ◽  
Xiangren Yi
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Tai Chi ◽  
Diastolic Pressure ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Controlled Trials ◽  
Bias Assessment ◽  
Randomized Controlled

Objectives. The purpose of this study was to investigate the influences of Tai Chi on blood pressure (BP) using the meta-analysis. Methods. This paper used 6 e-resource databases, and randomized controlled trials on the role of Tai Chi on blood pressure were retrieved. Besides, the meta-analysis was conducted according to the guidelines of the Moose-recommendations and applied with Review Manager 5.3, and the risk of bias assessment was performed with the Cochrane Collaboration’s tool. The inclusion, data extraction, and risk of bias assessment were independently finished by two researchers. Results. There are 24 trials meeting the criteria of inclusion and the results were reviewed. The meta-analysis indicates that, compared with no exercise, Tai Chi had the influence of lowering systolic blood pressure (mean difference = −6.07, 95%CI (−8.75, −3.39), P < 0.00001 ) and diastolic blood pressure (mean difference MD = −3.83, 95%CI (−4.97, −2.69), P < 0.00001 ). No significant discrepancies in all outcomes between Tai Chi and other aerobic exercises were discovered. Conclusion. Tai Chi can significantly reduce systolic and diastolic pressure than inactivity. However, Tai Chi does not show advantages in reducing blood pressure compared to other aerobic exercises. The trial is registered with CRD42020175306.

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.

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