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Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis
- Source :
- Critical Reviews in Food Science and Nutrition. 59:2674-2687
- Publication Year :
- 2018
- Publisher :
- Informa UK Limited, 2018.
-
Abstract
- Pairwise meta-analyses have shown beneficial effects of individual dietary approaches on blood pressure but their comparative effects have not been established.Therefore we performed a systematic review of different dietary intervention trials and estimated the aggregate blood pressure effects through network meta-analysis including hypertensive and pre-hypertensive patients.PubMed, Cochrane CENTRAL, and Google Scholar were searched until June 2017. The inclusion criteria were defined as follows: i) Randomized trial with a dietary approach; ii) hypertensive and pre-hypertensive adult patients; and iii) minimum intervention period of 12 weeks. In order to determine the pooled effect of each intervention relative to each of the other intervention for both diastolic and systolic blood pressure (SBP and DBP), random effects network meta-analysis was performed.A total of 67 trials comparing 13 dietary approaches (DASH, low-fat, moderate-carbohydrate, high-protein, low-carbohydrate, Mediterranean, Palaeolithic, vegetarian, low-GI/GL, low-sodium, Nordic, Tibetan, and control) enrolling 17,230 participants were included. In the network meta-analysis, the DASH, Mediterranean, low-carbohydrate, Palaeolithic, high-protein, low-glycaemic index, low-sodium, and low-fat dietary approaches were significantly more effective in reducing SBP (-8.73 to -2.32 mmHg) and DBP (-4.85 to -1.27 mmHg) compared to a control diet. According to the SUCRAs, the DASH diet was ranked the most effective dietary approach in reducing SBP (90%) and DBP (91%), followed by the Palaeolithic, and the low-carbohydrate diet (ranked 3rd for SBP) or the Mediterranean diet (ranked 3rd for DBP). For most comparisons, the credibility of evidence was rated very low to moderate, with the exception for the DASH vs. the low-fat dietary approach for which the quality of evidence was rated high.The present network meta-analysis suggests that the DASH dietary approach might be the most effective dietary measure to reduce blood pressure among hypertensive and pre-hypertensive patients based on high quality evidence.
- Subjects :
- medicine.medical_specialty
Dietary Approaches To Stop Hypertension
030309 nutrition & dietetics
Diastole
Blood Pressure
Diet, Mediterranean
Industrial and Manufacturing Engineering
Prehypertension
law.invention
03 medical and health sciences
0404 agricultural biotechnology
Randomized controlled trial
law
Internal medicine
Dash
medicine
Humans
0303 health sciences
Adult patients
business.industry
04 agricultural and veterinary sciences
General Medicine
Diet, Sodium-Restricted
Random effects model
040401 food science
Blood pressure
Meta-analysis
Hypertension
business
Food Science
Subjects
Details
- ISSN :
- 15497852 and 10408398
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- Critical Reviews in Food Science and Nutrition
- Accession number :
- edsair.doi.dedup.....8d0f06e307c286ad9197c8d2c0a13f07