Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis

Background. Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension. Methods. Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed. Results. It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = −5.94, 95% CI: −8.57, −3.30; diastolic blood pressure (DBP): WMD = −2.66, 95% CI: −3.66, −1.67), yoga (SBP: WMD = −5.09, 95% CI: −9.28, −0.89; DBP: WMD = −3.06, 95% CI: −5.16, −0.96), aquatic sports (SBP WMD = −7.53, 95% CI: −11.40, −3.65; DBP: WMD = −5.35, 95% CI: −9.00, −1.69), and football (SBP: WMD = −6.06, 95% CI: −9.30, −2.82; DBP: WMD = −5.55, 95% CI: −8.98, −2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = −8.31, 95% CI: −20.39, 3.77; DBP: WMD = −3.05, 95% CI: −6.96, 0.87) and Qigong (SBP: WMD = −4.34, 95% CI: −13.5, 4.82; DBP: WMD = −3.44, 95% CI: −7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high. Conclusion. Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.

Download Full-text

Effects of recreational sports and combined training on blood pressure and glycosylated hemoglobin in middle-aged and older adults: a systematic review and meta-analysis

10.1101/2021.05.05.21256401 ◽

2021 ◽

Author(s):

Vinicius Mallmann Schneider ◽

Paula de Azevedo Frank ◽

Sandra C. Fuchs ◽

Rodrigo Ferrari

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Glycosylated Hemoglobin ◽

Control Group ◽

Synthesis Methods ◽

Recreational Sports ◽

Middle Aged ◽

Exercise Interventions

Background Combined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve cardiometabolic profile and functional capacity in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to traditional exercises to improve these outcomes that could be used as a retention and continuity strategy, promoting health benefits associated with pleasure and satisfaction during the physical activity. Objectives The aim was to conduct a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON). Data Sources A literature search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Study Eligibility Criteria Studies that included men and women aged 45 years, healthy or with values of baseline for SBP 130mmHg or DBP 80 mmHg or with type II diabetes, in which the participants performed RS or CT versus CON, and evaluated SBP, DBP and HbA1c. Study Appraisal and Synthesis Methods Two independent reviewers screened search results, performed data extraction, and assessed of methodological quality of studies. Random effects modeling was used to compare pre to postintervention changes in BP and HbA1c from RS and CT versus CON, and the effect size were calculated through the weighted mean difference (MD) with a 95% confidence interval (CI). Conclusions RS and CT are effective exercise interventions to improve blood pressure in middle-aged and older adults. Additionally, CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of recreational sports to improve HbA1c.

Download Full-text

Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098903 ◽

2018 ◽

Vol 53 (24) ◽

pp. 1515-1525 ◽

Cited By ~ 10

Author(s):

Cheng Wang ◽

Jessica Redgrave ◽

Mohsen Shafizadeh ◽

Arshad Majid ◽

Karen Kilner ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Blood Pressure ◽

Transient Ischaemic Attack ◽

Meta Analysis ◽

Vascular Risk Factors ◽

Cochrane Library ◽

Vascular Risk ◽

Exercise Interventions ◽

Ischaemic Attack

ObjectiveSecondary vascular risk reduction is critical to preventing recurrent stroke. We aimed to evaluate the effect of exercise interventions on vascular risk factors and recurrent ischaemic events after stroke or transient ischaemic attack (TIA).DesignIntervention systematic review and meta-analysis.Data sourcesOVID MEDLINE, PubMed, The Cochrane Library, Web of Science, The National Institute for Health and Care Excellence, TRIP Database, CINAHL, PsycINFO, SCOPUS, UK Clinical Trials Gateway and the China National Knowledge Infrastructure were searched from 1966 to October 2017.Eligibility criteriaRandomised controlled trials evaluating aerobic or resistance exercise interventions on vascular risk factors and recurrent ischaemic events among patients with stroke or TIA, compared with control.ResultsTwenty studies (n=1031) were included. Exercise interventions resulted in significant reductions in systolic blood pressure (SBP) −4.30 mm Hg (95% CI −6.77 to −1.83) and diastolic blood pressure −2.58 mm Hg (95% CI −4.7 to −0.46) compared with control. Reduction in SBP was most pronounced among studies initiating exercise within 6 months of stroke or TIA (−8.46 mm Hg, 95% CI −12.18 to −4.75 vs −2.33 mm Hg, 95% CI −3.94 to −0.72), and in those incorporating an educational component (−7.81 mm Hg, 95% CI −14.34 to −1.28 vs −2.78 mm Hg, 95% CI −4.33 to −1.23). Exercise was also associated with reductions in total cholesterol (−0.27 mmol/L, 95% CI −0.54 to 0.00), but not fasting glucose or body mass index. One trial reported reductions in secondary vascular events with exercise, but was insufficiently powered.SummaryExercise interventions can result in clinically meaningful blood pressure reductions, particularly if initiated early and alongside education.

Download Full-text

Meta-Analysis: Acupuncture Therapy in Reducing Blood Pressure on Hypertensive Patients

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.05.53 ◽

2020 ◽

Author(s):

Fahmi Eko Susilo ◽

◽

Hanung Prasetya ◽

Agus Kristiyanto ◽

◽

...

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trial ◽

Acupuncture Therapy ◽

Controlled Trial ◽

Meta Analysis ◽

Blood Pressure Reduction ◽

Reduce Blood Pressure ◽

Sham Acupuncture ◽

Hypertensive Patients ◽

Randomized Controlled

Background: Blood pressure control is an important component of cardiovascular disease prevention. Despite the advances in the treatment of hypertension; effective management remains poor. Studies have shown that acupuncture facilitated a significant reduction in blood pressure. The purpose of this study was to examine the effectiveness of acupuncture therapy in reducing blood pressure on hypertensive patients. Subjects and Method: This was a meta-analysis and systematic review. The study was conducted by collected articles from PubMed, Google Schoolar, Mendeley, and Hindawi databases. Keywords used “acupuncture hypertension” OR “acupuncture high blood pressure” AND “efficacy acupuncture” AND “hypertension” AND “effect acupuncture for hypertension” AND “randomized controlled trial” AND “visual analogue scale”. The study population was patients with hypertension. The intervention was acupuncture. The comparison was sham acupuncture. The outcome was blood pressure reduction. The inclusion criteria were full text with English language and using randomized controlled trial study design. The selected articles were analyzed by PRISMA flow diagram and RevMan 5.3. Results: 7 articles were studied. There was high heterogeneity between experiment groups (I2= 66%; p= 0.007). Acupuncture therapy was more effective to reduce blood pressure than sham acupuncture (Standardized Mean Difference= 0.13; 95% CI= -0.13 to 0.39; p= 0.320). Conclusion: Acupuncture therapy is effective to reduce blood pressure in patients with hypertension. Keywords: hypertension, acupuncture Correspondence: Fahmi Eko Susilo. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081393644991. DOI: https://doi.org/10.26911/the7thicph.05.53

Download Full-text

Effects of qigong on systolic and diastolic blood pressure lowering: a systematic review with meta-analysis and trial sequential analysis

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03172-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Siew Mooi Ching ◽

Naidu Ragubathi Mokshashri ◽

Maharajan Mari Kannan ◽

Kai Wei Lee ◽

Nurin Amalina Sallahuddin ◽

...

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Sequential Analysis ◽

Controlled Trial ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Blood Pressure Reduction ◽

Trial Sequential Analysis ◽

Control Group ◽

Cochrane Central Register

Abstract Background The benefits of qigong for systolic and diastolic blood pressure (BP) reduction have been noted in previously published systematic reviews; however, the data on its effectiveness has been at best scarce. We aimed to update the evidence of qigong on blood pressure reduction after taking into consideration the risks of random error and reliability of data in the cumulative meta-analysis using trial sequential analysis (TSA). Methods Included trials were assessed using Cochrane risk of bias instrument. We performed meta-analysis with random-effects model and random errors were evaluated with TSA. We performed the search for the eligible randomized controlled trial (RCT) through Medline, Cinahl, Cochrane Central Register of Controlled Trials and also PubMed. Results A total of 370 subjects sourced from seven eligible RCTs were entered into the analysis. The pooled results demonstrated the significant reduction with the use of qigong of the systolic blood pressure [weighted mean difference (WMD), − 10.66 mmHg (95% confidence interval (CI) = − 17.69,-3.62, p < 0.001] and diastolic BP [WMD, − 6.76 mmHg, 95% CI = − 12.22, − 1.30, p < 0.001] as compared to the control group. Conclusions Significant reductions in BP is seen with the use of qigong as compared with the control group, suggesting that qigong may be used as a complementary therapy in the somewhat complicated management of hypertension.

Download Full-text

Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-016053 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016053 ◽

Cited By ~ 11

Author(s):

Tong Zhao ◽

Baomin Chen ◽

Yingying Zhou ◽

Xinyi Wang ◽

Yuanyuan Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Subclinical Hypothyroidism ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Density Lipoprotein ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cochrane Library ◽

Controlled Trials ◽

Media Thickness

BackgroundSubclinical hypothyroidism (SCH) has been associated with increased carotid intima-media thickness (C-IMT) in recent studies, but the effects of levothyroxine (L-T4) therapy on C-IMT in SCH patients are still controversial.AimTo evaluate the effect of L-T4 therapy on endothelial function as determined by C-IMT in patients with SCH.MethodsBeforeJuly 2016, we searched the PubMed, Embase, Cochrane Library and Google Scholar databases, selecting published randomised controlled trials (RCTs) and self-controlled trials for the meta-analysis.ResultsThree RCTs with 117 patients were considered appropriate for the meta-analysis. The results of the meta-analysis indicated that L-T4 significantly decreased the development of C-IMT (weighted mean difference (WMD) −0.05 mm, 95% CI −0.08 to –0.01 mm; p=0.025). We also analysed nine studies (self-controlled trials) with 247 patients and extracted the IMT of SCH patients before and after L-T4 treatment. After L-T4 therapy, the pooled estimate of the WMD of decreased C-IMT was −0.04 mm (95% CI −0.07 to –0.02 mm; p=0.05). Subgroup analysis showed that L-T4 therapy was associated with a decrease in C-IMT among patients of mixed genders (WMD −0.03 mm, 95% CI −0.06 to –0.01 mm; p=0.145). L-T4 therapy was associated with a decrease in C-IMT among female patients (WMD −0.07 mm, 95% CI −0.14 to –0.01; p=0.186). Longer treatment (>6 months) also resulted in a significant decrease in C-IMT (WMD −0.05 mm, 95% CI −0.08 to –0.02; p=0.335).ConclusionThis meta-analysis indicates that L-T4 treatment of SCH patients can reduce C-IMT, possibly as a result of the reduction of total cholesterol, triglyceride, low density lipoprotein, systolic blood pressure, diastolic blood pressure, lipoprotein(a), and flow-mediated dilatation. Decreased C-IMT was observed in SCH patients after long-term (>6 months) L-T4 treatment. RCTs with larger samples are needed to verify these observations.

Download Full-text

Endothelial Function in Patients with Subclinical Hypothyroidism: A Meta-Analysis

Hormone and Metabolic Research ◽

10.1055/a-1018-9564 ◽

2019 ◽

Vol 51 (11) ◽

pp. 691-702 ◽

Cited By ~ 3

Author(s):

Ningning Gong ◽

Cuixia Gao ◽

Xuedi Chen ◽

Yuan Fang ◽

Limin Tian

Keyword(s):

Blood Pressure ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Subclinical Hypothyroidism ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Density Lipoprotein ◽

Thyroid Stimulating Hormone ◽

Cochrane Library ◽

Statistical Heterogeneity

AbstractThe purpose of this meta-analysis was to determine whether patients with subclinical hypothyroidism (SCH) have impaired endothelial function, which is assessed by carotid intima-media thickness (C-IMT) and flow-mediated dilatation (FMD) of brachial artery. PubMed, Embase and Cochrane Library databases and the key studies references were searched in our study, prior to July 2017 for all language articles about FMD or C-IMT in SCH and euthyroid subjects. Two authors screened documents and extracted data by pre-established standard independently. The pooled estimate for continuous data was calculated using random-effects models. Statistical heterogeneity was evaluated using I2 statistics. Subgroup analyses were conducted to assess the robustness of the meta-analysis. Publication bias was examined with funnel plot analysis and Egger’s test. In this meta-analysis, 10 studies with 760 subjects are related to FMD with SCH and 23 studies with 1521 subjects are related to C-IMT with SCH. The pooled estimate of the weighted mean difference (WMD) has revealed that SCH correlated with increased C-IMT [WMD 0.069 mm; 95% CI (0.042, 0.095); p<0.001] and decreased FMD [WMD −1.848%; 95% CI (−2.298, −1.399); p<0.001] with high heterogeneity. Compared with EU controls, SCH was also associated with an increased diastolic blood pressure (DBP), systolic blood pressure (SBP), triglyceride (TG), total cholesterol (TC) levels, and low density lipoprotein cholesterol (LDL-C). This meta-analysis demonstrates that SCH is associated with endothelial dysfunction, which may relate with increased thyroid-stimulating hormone (TSH). Hypertension and dyslipidemia may play a crucial part in the development of endothelial dysfunction.

Download Full-text

The Effect of Saffron Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

Nutrients ◽

10.3390/nu13082736 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2736

Author(s):

Leila Setayesh ◽

Damoon Ashtary-Larky ◽

Cain C. T. Clark ◽

Mahnaz Rezaei Kelishadi ◽

Pardis Khalili ◽

...

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trials ◽

Diastolic Blood Pressure ◽

Metabolic Diseases ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Clinical Importance ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled

Background: The favorable influences of saffron supplementation on metabolic diseases have previously been shown. We aimed to assess the effects of saffron supplementation on blood pressure in adults. Methods: A systematic search was performed in Scopus, Embase, and the Cochrane library databases to find randomized controlled trials (RCTs) related to the effect of saffron supplementation on blood pressure in adults up to March 2021. The primary search yielded 182 publications, of which eight RCTs were eligible. Results: Our results showed that saffron supplementation resulted in a significant decrease in systolic blood pressure (weighted mean difference (WMD): −0.65 mmHg; 95% CI: −1.12 to −0.18, p = 0.006) and diastolic blood pressure (DBP) (WMD: −1.23 mmHg; 95% CI: −1.64 to −0.81, p < 0.001). Moreover, saffron supplementation reduced DBP in a non-linear fashion, based on duration (r = −2.45, p-nonlinearity = 0.008). Conclusions: Saffron supplementation may significantly improve both systolic and diastolic blood pressure in adults. It should be noted that the hypotensive effects of saffron supplementation were small and may not reach clinical importance.

Download Full-text

Device therapy of resistant hypertension

Orvosi Hetilap ◽

10.1556/oh.2013.29543 ◽

2013 ◽

Vol 154 (6) ◽

pp. 203-208 ◽

Cited By ~ 1

Author(s):

Gábor Simonyi ◽

J. Róbert Bedros ◽

Mihály Medvegy

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Resistant Hypertension ◽

Carotid Sinus ◽

Maximum Tolerated Dose ◽

Reduce Blood Pressure ◽

Nerve Fibers ◽

Uncontrolled Hypertension ◽

Sympathetic Nerve Fibers ◽

Treatment Of Hypertension

It is well known that hypertension is an independent cardiovascular risk factor. Treatment of hypertension frequently includes administration of three or more drugs. Resistant hypertension is defined when blood pressure remains above target value despite full doses (the patient’s maximum tolerated dose) of antihypertensive medication consisting of at least three different classes of drugs including a diuretic. Pharmacological treatment of hypertension is often unsuccessful despite the increasing number of drug combinations. Uncontrolled hypertension, however, increases the cardiovascular risk. Device treatment of resistant hypertension is currently testing two major fields. One of them the stimulation of baroreceptors in the carotid sinus and the other is radiofrequency ablation of sympathetic nerve fibers around renal arteries to reduce blood pressure in drug resistant hypertension. Orv. Hetil., 2013, 154, 203–208.

Download Full-text

PENGARUH PEMBERIAN BELIMBING DAN MENTIMUN TERHADAP PENDERITA HIPERTENSI DI DESA LAU KERSIK KECAMATAN GUNUNG SITEMBER KABUPATEN DAIRI

Jurnal Penelitian Keperawatan Medik ◽

10.36656/jpkm.v2i1.189 ◽

2019 ◽

Vol 2 (1) ◽

pp. 18-23

Author(s):

Herri Novita Br Tarigan ◽

Prista Hotmarina Purba

Keyword(s):

Blood Pressure ◽

Data Analysis ◽

Fruit Juice ◽

Blood Pressure Reduction ◽

Reduce Blood Pressure ◽

Pharmacological Therapy ◽

Hypertensive Patients ◽

Star Fruit ◽

Equivalent Time ◽

Life Threatening

Hypertension is a disease that is not uncommon in the community, including the Bukit Lau Kersik village. People with hypertension often do not show long-term symptoms and can be life-threatening. However, one of the management of hypertension that can be used as non-pharmacological therapy is consuming starfruit juice and cucumber which is quite easy to find in the Bukit Lau Kersik village. This combination of juices contains potassium which can reduce blood pressure in patients with hypertension. This study used Equivalent Time Sample Design with 14 subjects with hypertension in the Bukit Lau Kersik Village, Gunung Sitember Subdistrict, Dairi District. The technique of this research sample used Non-Probability Sampling with Saturated Sampling. The instrument used was a sphygmomanometer and a stethoscope. Bivariate data analysis in this study was the Wilcoxon statistical test. Based on the data analysis performed, the value of p = 0.011 (p= < 0.05) was obtained, meaning that there was a significant relationship between giving star fruit juice and cucumber to hypertensive patients. Then it can be concluded that there is an influence between giving star fruit and cucumber juice to blood pressure reduction in hypertensive patients in Bukit Lau Kersik Village Gunung Sitember Subdistrict, Dairi District in 2019. Suggestion: The factors that affect blood pressure in hypertensive patients and checking blood pressure before drinking star fruit juice and cucumber.

Download Full-text

Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211032786 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110327

Author(s):

Weihua Liu ◽

Wenli Yu ◽

Hongli Yu ◽

Mingwei Sheng

Keyword(s):

Clinical Efficacy ◽

Lower Risk ◽

Gastrointestinal Endoscopy ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Similar Efficacy ◽

Cochrane Library ◽

Efficacy And Safety ◽

Inclusion Criteria ◽

Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

Download Full-text