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

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

Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

Nutrients ◽

10.3390/nu12061604 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1604

Author(s):

Kai Wei Lee ◽

Hong Chuan Loh ◽

Siew Mooi Ching ◽

Navin Kumar Devaraj ◽

Fan Kee Hoo

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Sequential Analysis ◽

Relative Effectiveness ◽

Blood Pressure Reduction ◽

Vegetarian Diet ◽

Vegan Diet ◽

Trial Sequential Analysis ◽

Cochrane Central Register ◽

Vegetarian Diets

The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), −2.66 mmHg (95% confidence interval (CI) = −3.76, −1.55, p < 0.001) and diastolic BP was WMD, −1.69 95% CI = −2.97, −0.41, p < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, −3.12 mmHg; 95% CI = −4.54, −1.70, p < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, −1.75 mmHg, 95% CI −5.38, 1.88, p = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, −1.92 mmHg (95% CI = −3.18, −0.66, p < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), p = 0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.

Download Full-text

A Meta-Analysis of Different Types of Cardiac Adipose Tissue in HIV Patients

BioMed Research International ◽

10.1155/2020/8234618 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Guang Song ◽

Wei Qiao ◽

Lu Sun ◽

Xiaona Yu

Keyword(s):

Adipose Tissue ◽

Sequential Analysis ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Mean Difference ◽

Trial Sequential Analysis ◽

Control Group ◽

Hiv Patients ◽

Standard Mean Difference ◽

Different Types

Background. Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods. Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results. In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness ( SMD = 0.59 , 95% CI: 0.24–0.95, P = 0.001 ; SMD = 1.10 , 95% CI: 0.41–1.79, P = 0.002 ); however, the EAT volume and PCF volume were unchanged in the HIV group ( SMD = 0.16 , 95% CI: -0.07–0.39, P = 0.169 ; WMD = 10.78 , 95% CI: -14.11–35.67, P = 0.396 ). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions. EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.

Download Full-text

Effects of cinnamon supplementation on systolic and diastolic blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials

Critical Comments in Biomedicine ◽

10.18502/ccb.v2i1.5871 ◽

2021 ◽

Author(s):

Zeinab Yazdanpanah ◽

Mandana Amiri ◽

Azadeh Nadjarzadeh ◽

Hadis Hooshmandi ◽

Maryam Azadi-Yazdi

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Clinical Trials ◽

Diastolic Blood Pressure ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Controlled Clinical Trials ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled

Introduction: Hypertension is a chronic condition that might lead to renal and cardiovascular diseases. The previous trials examining the effect of cinnamon supplementation on blood pressure have led to conflicting results. The present systematic review aimed to summarize the effect of cinnamon supplementation on blood pressure using a meta-analysis of published randomized controlled clinical trials. Methods: To identify the eligible articles, MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched from inception until September 2019 for relevant articles. The risk of bias assessment was performed using the Cochrane collaboration tool. A Random-effects model was applied to calculate the summary effects. Results: Totally, 11 trials with 686 participants were included in this systematic review and meta-analysis. The dose of cinnamon supplement consumption varied from 500 to 10000 mg/d. The meta-analysis revealed that cinnamon supplementation significantly decreases systolic blood pressure (SBP) [WMD (weighted mean difference)= -5.72 mmHg, 95% confidence interval (CI): -8.63 to -2.80; P<0.001, I2= 81.1)] and diastolic blood pressure (DBP) (WMD= -4.06 mmHg, 95% CI: -6.68 to -1.44; P= 0.002, I2 = 88.6). Subgroup analysis suggested no significant reduction of DBP in subjects with diabetes (WMD= -2.015 mmHg, 95% CI: -4.55 to 0.52; P= 0.12, I2 = 72.3) and prediabetes or metabolic syndrome (WMD= -4.8 mmHg, 95% CI: -10.06 to 0.44; P= 0.073, I2= 92.5). Conclusions: Cinnamon supplementation could be beneficial in lowering SBP and DBP in adults. Further studies with different doses are recommended to conﬁrm the present findings.

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

Traction Therapy for Cervical Radicular Syndrome is Statistically Significant but not Clinically Relevant for Pain Relief. A Systematic Literature Review with Meta-Analysis and Trial Sequential Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9113389 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3389

Author(s):

Claudio Colombo ◽

Stefano Salvioli ◽

Silvia Gianola ◽

Greta Castellini ◽

Marco Testa

Keyword(s):

Sequential Analysis ◽

Meta Analysis ◽

Risk Of Bias ◽

Treatment Modalities ◽

Trial Sequential Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Quality Of Evidence ◽

Radicular Syndrome

Aim: We aimed to investigate the effectiveness of traction therapy in reducing pain by performing a systematic review with meta-analysis. We also explore the best modality for administering traction to patients with cervical radicular syndrome (CRS). Methods: We searched the Medline, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) electronic databases. Two reviewers independently selected randomized controlled trials (RCTs) that compared traction in addition to other treatments versus the effectiveness of other treatments alone for pain outcome. We calculated the mean differences (MDs) and 95% confidence intervals (CIs). We used Cochrane’s tool to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the quality of evidence and summarize the study conclusions. Results: A total of seven studies (589 patients), one with low risk of bias, were evaluated. An overall estimate of treatment modalities showed low evidence that adding traction to other treatments is statistically significant (MD −5.93 [95% CI, −11.81 to −0.04] P = 0.05 and I2 = 57%) compared to other treatments alone. The subgroup analyses were still statistically significant only for mechanical and continuous modalities. Conclusions: Overall analysis showed that, compared to controls, reduction in pain intensity after traction therapy was achieved in patients with cervical radiculopathy. However, the quality of evidence was generally low and none of these effects were clinically meaningful.

Download Full-text

Do low-dose corticosteroids improve survival or shock reversal from septic shock in adults? Meta-analysis with trial sequential analysis

Journal of International Medical Research ◽

10.1177/0300060518774985 ◽

2018 ◽

Vol 46 (7) ◽

pp. 2513-2524 ◽

Cited By ~ 4

Author(s):

Rui Xu ◽

Qian Wang ◽

Yan Huang ◽

Ling Wu ◽

Qi Liu ◽

...

Keyword(s):

Septic Shock ◽

Relative Risk ◽

Confidence Interval ◽

Sequential Analysis ◽

Low Dose ◽

Meta Analysis ◽

Cochrane Library ◽

Trial Sequential Analysis ◽

Control Group ◽

Shock Reversal

Objective This meta-analysis with trial sequential analysis (TSA) was performed to determine whether low-dose corticosteroids (LDCs) can improve survival or shock reversal from septic shock in adults. Methods A literature search was performed using several databases (Medline, Cochrane Library, Embase, and Chinese Biological Medical Database) until 23 October 2017. The systematic review was registered in PROSPERO. Results Nine randomized controlled trials (RCTs) (n = 1182) were included. LDC intervention improved 7-day shock reversal compared with the control group (relative risk, 1.36; TSA-adjusted 95% confidence interval, 1.20–1.54). LDCs had no statistically significant effects on gastrointestinal bleeding or superinfection. LDCs did not reduce 28-day mortality from septic shock (relative risk, 0.96; TSA-adjusted 95% confidence interval, 0.74–1.24). The TSA indicated that RCTs of about 3000 patients would be needed to draw definitive conclusions; similar results were obtained in a subgroup analysis of nonresponders. Conclusions LDCs improve 7-day shock reversal. However, whether LDCs improve 28-day survival from septic shock in adults remains unclear. The results of well-designed larger RCTs are needed.

Download Full-text

Meta-analysis and trial sequential analysis of LncRNA H19 polymorphic variants on susceptibility to cancer

10.21203/rs.3.rs-16371/v1 ◽

2020 ◽

Author(s):

Kunpeng Wang ◽

Zheng Zhu ◽

Yiqiu Wang ◽

Dayuan Zong ◽

Peng Xue ◽

...

Keyword(s):

Subgroup Analysis ◽

Sequential Analysis ◽

Cancer Susceptibility ◽

Human Cancer ◽

Meta Analysis ◽

Population Based ◽

Trial Sequential Analysis ◽

Control Group ◽

Cancer Risks ◽

Polymorphic Variants

Abstract Background: Although myriad researches upon the associations between LncRNA H19 polymorphic variants (rs2839698 G﹥A, rs3024270 C﹥G, rs2107425 C﹥T, rs2735971 A﹥G and rs217727 G﹥A) and the susceptibility to cancer have been conducted, these results remained contradictory and perplexing. Basing on that, a systematic review and updated meta-analysis was conducted to anticipate a fairly precise assessment about these associations. Methods: We retrieved the electronic databases EMBASE, PubMed and Web of Science for valuable academic studies before October 1st, 2019. Ultimately, 24 of which were encompassed after screening, and the available data was extracted and integrated. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) was adopted to evaluate the strength of these associations. For multi-level investigation, subgroup analysis derived from source of controls together with genotypic method was preformed. Eventually, 24 articles altogether embodying 52 studies were included. Results: The results illuminated that LncRNA H19 SNPs mentioned above were all irrelevant to cancer susceptibility. Nevertheless, crucial results were found concentrated in population-based control group when subgroup analysis by source of controls were performed in H19 mutation rs2839698 and rs2735971. Meanwhile, in the stratification analysis by genotypic method, apparent cancer risks were discovered by TaqMan method in H19 mutation rs2107425 and rs3024270. Then, trial sequential analysis (TSA) demonstrated that the results about such associations were firm evidence of effect, except rs2735971 polymorphism. Conclusion: Therefore, this meta-analysis indicated that LncRNA H19 SNPs were not associated with the susceptibility to human cancer. However, after the stratification analysis, inconsistent results still existed in different genotypic method and source of control. Thus, more high-quality studies on cancer patients of different factors were needed to confirm these findings.

Download Full-text

Efektivitas Terapi Rendam Kaki Air Hangat terhadap Perubahan Penurunan Tekanan Darah Ibu Hamil Preeklampsia

Jurnal Kebidanan Harapan Ibu Pekalongan ◽

10.37402/jurbidhip.vol8.iss1.118 ◽

2021 ◽

Vol 8 (1) ◽

pp. 24-31

Author(s):

Maslahatul Inayah ◽

Tri Anonim

Keyword(s):

Blood Pressure ◽

Maternal Mortality ◽

Pregnant Women ◽

Diastolic Blood Pressure ◽

Blood Pressure Reduction ◽

Intervention Group ◽

Warm Water ◽

Bivariate Analysis ◽

Control Group ◽

Pregnancy And Postpartum

Maternal Mortality Rate (MMR) can be a measuring tool to determine the quality of health services both during pregnancy and postpartum. Pregnant women with preeclampsia can cause complications that lead to increased maternal mortality and perinatal mortality. There are several attempts to control high blood pressure. This method can use pharmacological or non pharmacological. The purpose of this study was to determine the effectiveness of warm water foot soak therapy on changes in blood pressure reduction of preeclamptic pregnant women. This type of research is a quantitative study with aresearch quasi-experimentaldesign, with adesign approach pre and post test in the intervention group and the conMtrol group. The sample for each group is 10 people, so that the total number of samples is 20 respondents.Bivariate analysis was performed using the Wilxocon test because the data distribution was not normal and the Mann-Whitney Test to determine the difference before and after the intervention was given.The results of the bivariate analysis showed that there was an effect of giving warm water foot soaking therapy to changes in the decrease in systolic and diastolic blood pressure of preeclamptic pregnant women with a value of p = 0.004 and p = 0.011 and there were differences in changes in the decrease in systolic and diastolic blood pressure between the intervention group and the control group. p = 0.001 and p = 0.007.

Download Full-text

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

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2022/2453805 ◽

2022 ◽

Vol 2022 ◽

pp. 1-13

Author(s):

Zhu Zhu ◽

Wu Yan ◽

Qiurun Yu ◽

Peihao Wu ◽

Francis Manyori Bigambo ◽

...

Keyword(s):

Blood Pressure ◽

Tai Chi ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Blood Pressure Reduction ◽

Reduce Blood Pressure ◽

Cochrane Library ◽

Lifestyle Behaviour ◽

Exercise Interventions ◽

Treatment Of Hypertension

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

Effect of Extracorporeal Blood Purification on Mortality in Sepsis: A Meta-Analysis and Trial Sequential Analysis

Blood Purification ◽

10.1159/000510982 ◽

2020 ◽

pp. 1-11

Author(s):

Timothy A.C. Snow ◽

Shona Littlewood ◽

Carlos Corredor ◽

Mervyn Singer ◽

Nishkantha Arulkumaran

Keyword(s):

Sequential Analysis ◽

Meta Analysis ◽

Blood Purification ◽

Trial Sequential Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Mortality Benefit ◽

Nonspecific Adsorption ◽

Extracorporeal Blood ◽

Extracorporeal Blood Purification

Objective: The objective of this study was to conduct a meta-analysis and trial sequential analysis (TSA) of published randomized controlled trials (RCTs) to determine whether mortality benefit exists for extracorporeal blood purification techniques in sepsis. Data Sources: A systematic search on MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for RCTs was performed. Study Selection: RCTs investigating the effect of extracorporeal blood purification device use on mortality among critically ill septic patients were selected. Data Extraction: Mortality was assessed using Mantel-Haenszel models, and I2 was used for heterogeneity. Data are presented as odds ratios (OR); 95% confidence intervals (CIs); p values; I2. Using the control event mortality proportion, we performed a TSA and calculated the required information size using an anticipated intervention effect of a 14% relative reduction in mortality. Data Synthesis: Thirty-nine RCTs were identified, with 2,729 patients. Fourteen studies used hemofiltration (n = 789), 17 used endotoxin adsorption devices (n = 1,363), 3 used nonspecific adsorption (n = 110), 2 were cytokine removal devices (n = 117), 2 used coupled plasma filtration adsorption (CPFA) (n = 207), 2 combined hemofiltration and perfusion (n = 40), and 1 used plasma exchange (n = 106). On conventional meta-analysis, hemofiltration (OR 0.56 [0.40–0.79]; p < 0.001; I2 = 0%), endotoxin removal devices (OR 0.40 [0.23–0.67], p < 0.001; I2 = 71%), and nonspecific adsorption devices (OR 0.32 [0.13–0.82]; p = 0.02; I2 = 23%) were associated with mortality benefit, but not cytokine removal (OR 0.99 [0.07–13.42], p = 0.99; I2 = 64%), CPFA (OR 0.50 [0.10–2.47]; p = 0.40; I2 = 64%), or combined hemofiltration and adsorption (OR 0.71 [0.13–3.79]; p = 0.69; I2 = 0%). TSA however revealed that based on the number of existing patients recruited for RCTs, neither hemofiltration (TSA-adjusted CI 0.29–1.10), endotoxin removal devices (CI 0.05–3.40), nor nonspecific adsorption devices (CI 0.01–14.31) were associated with mortality benefit. Conclusion: There are inadequate data at present to conclude that the use of extracorporeal blood purification techniques in sepsis is beneficial. Further adequately powered RCTs are required to confirm any potential mortality benefit, which may be most evident in patients at greatest risk of death.

Download Full-text