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1.
The effect of grape (Vitis vinifera) seed extract supplementation on flow-mediated dilation, blood pressure, and heart rate: A systematic review and meta-analysis of controlled trials with duration- and dose-response analysis.
Foshati, S, Nouripour, F, Sadeghi, E, Amani, R
Pharmacological research. 2022;:105905
Abstract
The objective of this systematic review and meta-analysis of controlled trials was to assess the long-term effect of grape seed extract (GSE) supplementation on flow-mediated dilation (FMD), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in adults. Web of Science, Scopus, Medline, Cochrane Library, and Google Scholar were searched up to May 24, 2021. Nineteen trials were included in this study. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using a random-effects model. GSE supplementation significantly reduced DBP (WMD: -2.20 mmHg, 95% CI: -3.79 to -0.60, I2 = 88.8%) and HR (WMD: -1.25 bpm, 95% CI: -2.32 to -0.19, I2 = 59.5%) but had no significant effects on FMD (WMD: 1.02%, 95% CI: -0.62 to 2.66, I2 = 92.0%) and SBP (WMD: -3.55 mmHg, 95% CI: -7.59 to 0.49, I2 = 97.4%). Subgroup analysis revealed that the dose and duration of GSE administration and the characteristics of study participants could be sources of between-study heterogeneity. Significant non-linear relationships were found between DBP and the duration of GSE supplementation (P = 0.044) and its dose (P = 0.007). In conclusion, GSE may be beneficial for individuals with or at risk of cardiovascular disease because it may have hypotensive and HR-lowering properties.
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2.
Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis.
de Heus, RAA, Tzourio, C, Lee, EJL, Opozda, M, Vincent, AD, Anstey, KJ, Hofman, A, Kario, K, Lattanzi, S, Launer, LJ, et al
Hypertension (Dallas, Tex. : 1979). 2021;(5):1478-1489
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Impact of the level of adherence to the Mediterranean Diet on blood pressure: A systematic review and meta-analysis of observational studies.
Bakaloudi, DR, Chrysoula, L, Leonida, I, Kotzakioulafi, E, Theodoridis, X, Chourdakis, M
Clinical nutrition (Edinburgh, Scotland). 2021;(12):5771-5780
Abstract
BACKGROUND High blood pressure (BP) constitutes a common and serious medical condition which is rising globally, and is among preventable factors for cardiovascular, renal, brain and other diseases. Modifiable risk factors of high BP include unhealthy dietary patterns, presence of obesity, excess alcohol consumption and lack of physical activity. Data in regard to the different types of diets show that Mediterranean diet (MD) is associated with healthy levels of BP. In this study we aimed to investigate the impact of the level of adherence to MD in BP. AIMS-METHODS A systematic literature search (up to 08.2021) in PubMed, Scopus, Embase, Web of Science, Cochrane and Google Scholar databases was conducted, and 54 observational studies were included. RESULTS Systolic blood pressure (SBP) was found to be lower in the high adherence to MD group SMD: -0.08, (95%CI: -0.15, -0.02) whereas no differences regarding diastolic blood pressure (DBP) were observed between the high and low adherence to MD groups [SMD: -0.07, (95%CI: -0.13, 0.00)]. Mean DBP of all included studies for both high and low adherence groups were in healthy levels (<90 mmHg). CONCLUSIONS Higher adherence to MD could positively influence SBP, but further research is needed in this field due to the heterogeneous definitions of low/high adherence and the type of studies used (observational).
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The effects of capsinoids and fermented red pepper paste supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials.
Amini, MR, Sheikhhossein, F, Bazshahi, E, Hajiaqaei, M, Shafie, A, Shahinfar, H, Azizi, N, Eghbaljoo Gharehgheshlaghi, H, Naghshi, S, Fathipour, RB, et al
Clinical nutrition (Edinburgh, Scotland). 2021;(4):1767-1775
Abstract
BACKGROUND & AIMS The present systematic review and meta-analysis were conducted to investigate the effects of capsinoids and fermented red pepper paste (FRPP) supplementation on Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). METHODS Relevant studies, published up to May 2020, were searched through PubMed/Medline, Scopus, ISI Web of Science, Embase, and Google Scholar. All randomized clinical trials investigating the effect of capsinoids and FRPP supplementation on blood pressure including SBP and DBP were included. RESULTS Out of 335 citations, 7 trials that enrolled 363 subjects were included. Capsinoids and FRPP resulted in significant reduction in DBP (Weighted mean differences (WMD): -1.90 mmHg; 95% CI, -3.72 to -0.09, P = 0.04) but no significant change in SBP (WMD: 0.55 mmHg, 95% CI: -1.45, 2.55, P = 0.588). FRPP had a significant reduction in SBP. Greater effects on SBP were detected in trials, lasted ≥12 weeks, and sample size >50. Capsinoids with dosage ≤200 and FRPP with dosage of 11.9 g significantly decreased DBP. CONCLUSION Overall, these data suggest that supplementation with FRPP may play a role in improving SBP and DBP but for capsinoids no effects detected in this analysis on SBP and DBP.
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Efficacy and Safety of LCZ696 for Short-term Management of Essential Hypertension Compared With ARBs: A Meta-analysis of Randomized Controlled Trials.
Yang, S, Zhang, H, Yang, P, Wang, C, Wu, Q
Journal of cardiovascular pharmacology. 2021;(5):650-659
Abstract
Whether LCZ696 (neprilysin inhibitor + valsartan) has greater advantages of blood pressure (BP) lowering than angiotensin II type 1 receptor blockers (ARBs) is unclear. To provide more detailed information about the benefits of LCZ696, we conducted a meta-analysis to evaluate the efficacy and safety of LCZ696 for short-term management of hypertension compared with ARBs. We searched PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov, using relevant keywords. We used a random or fixed effects model to calculate the weighted mean difference (WMD) of changes in BP and the risk ratio (RR) for BP control rates and adverse events (AEs). In this meta-analysis, 9 studies were incorporated. Compared with ARBs, LCZ696 revealed a significant reduction in mean sitting systolic BP [msSBP; WMD -4.79 mm Hg; 95% confidence interval (CI): -5.46 to -4.11 mm Hg], mean sitting diastolic BP (msDBP; WMD -2.12 mm Hg; 95% CI: -2.53 to -1.71 mm Hg), mean sitting pulse pressure (msPP; WMD -2.79 mm Hg; 95% CI: -3.52 to -2.07 mm Hg), and mean ambulatory pulse pressure (maPP; WMD -2.96 mm Hg; 95% CI: -3.35 to -2.57 mm Hg). LCZ696 had a higher BP control rate than ARBs (OR = 1.55; 95% CI: 1.39 to 1.73). There was no significant difference between LCZ696 and ARBs in the incidence of AEs (RR = 1.10; 95% CI: 0.96 to 1.25) and discontinuations because of AEs (RR = 0.97; 95% CI: 0.54 to 1.32). Overall, in short-term treatment, LCZ696 has greater advantages of antihypertensive efficacy and the safety is not inferior to ARBs. Further long-term studies are required to rule out the potential risks of beta amyloid accumulation and the potential for Alzheimer's disease.
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Effect of Spirulina Supplementation on Systolic and Diastolic Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Machowiec, P, Ręka, G, Maksymowicz, M, Piecewicz-Szczęsna, H, Smoleń, A
Nutrients. 2021;(9)
Abstract
Spirulina is a microalga that presents various important pro-health properties, for instance lowering blood pressure in the research. The study aims to appraise the efficacy of Spirulina administration on systolic (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved by a systematic search of PubMed, Web of Science, and the Cochrane Library databases from inception to June 2021 according to a standardized protocol. The effect size of each study was counted from mean and standard deviation before and after the intervention and shown as Un-standardized mean difference and 95% confidence interval. Sensitivity analyses were performed. Meta-analysis on 5 RCTs with 230 subjects was eligible. The amount of Spirulina ranged from 1 to 8 g per day, and intervention durations ranged from 2 to 12 weeks. Data analysis indicated that Spirulina supplementation led to a significant lowering of SBP (Mean Difference (MD): -4.59 mmHg, 95% Confidence Interval (CI): -8.20 to -0.99, I square statistic (I2) = 65%) and significant lowering of DBP (MD: -7.02 mmHg, CI: -8.86 to -5.18, I2 = 11%), particularly in a subgroup of hypertensive patients. Spirulina administration might have a supportive effect on the prevention and treatment of hypertension. More exact randomized controlled trials are needed to clarify the effect of Spirulina supplementation on blood pressure.
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A systematic review and meta-analysis of effects of spironolactone on blood pressure, glucose, lipids, renal function, fibrosis and inflammation in patients with hypertension and diabetes.
Lin, M, Heizati, M, Wang, L, Nurula, M, Yang, Z, Wang, Z, Abudoyreyimu, R, Wu, Z, Li, N
Blood pressure. 2021;(3):145-153
Abstract
PURPOSE Hypertension commonly co-exists with diabetes mellitus (DM), and both are closely related to adverse health outcomes. The activation of aldosterone and mineralocorticoid receptor (MR) may play important roles in this process. Therefore, we aim to evaluate the efficacy of MR antagonists on cardiovascular risk factors, including blood pressure (BP), glucose, lipids, renal function, fibrosis and inflammatory and its safety in patients with both hypertension and DM. METHODS We searched PubMed, Embase, Web of Science and Cochrane databases for clinical trials published until December 31, 2019. Studies comparing the effect of spironolactone to placebo in patients with hypertension and DM were included. Mean difference with 95% confidence intervals was used to report outcomes. RESULTS Eleven randomised placebo-controlled trials with 640 participants were finally included with mean follow-up of 5 months. Compared to placebo, spironolactone significantly reduced office systolic (-6.57, 95%CI: -9.21, -3.93) and diastolic BP (-2.63, 95%CI: -4.25, -1.02) as well as ambulatory BP; increased glycosylated haemoglobin by 0.3 but no clear effect on fasting glucose. Spironolactone induced a significantly reduction of urinary albumin but increased serum creatinine (7.60, 95%CI: 4.94, 10.27) and decreased glomerular filtration rate (-4.28, 95%CI: -6.38, -2.18). Markers of fibrosis and inflammation, including NIIINP, PICP, hs-CRP and TNF-α were also decreased after spironolactone therapy. For lipid metabolism, there was no significant difference between groups. Spironolactone mildly increased serum potassium (0.30, 95%CI: 0.23, 0.37). 2.5% subjects treated with spironolactone experienced mild to moderate hyperkalaemia and received medication or dietary advice and another 1.6% developed severe hyperkalaemia and withdrawn from the studies. CONCLUSION Spironolactone reduced BP and urinary albumin, improve fibrosis and inflammation, whereas slightly increases the glycosylated haemoglobin and serum creatinine in patients with hypertension and diabetes. Long-term RCTs to assess the effects of spironolactone on cardiovascular events in this population are warranted.
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Effect of proanthocyanidins on blood pressure: A systematic review and meta-analysis of randomized controlled trials.
Ren, J, An, J, Chen, M, Yang, H, Ma, Y
Pharmacological research. 2021;:105329
Abstract
BACKGROUND Hypertension is a common chronic disease that can lead to serious health problems. Previous studies have not drawn a consistent conclusion about the effect of proanthocyanidins (PCs) on blood pressure (BP). This systematic review and meta-analysis aims to evaluate the effect of PCs supplementation on blood pressure (BP). METHODS A comprehensive literature search was performed in 6 databases (Pubmed, Scopus, ISI Web of Science, the Cochrane Library, Embase and Google Scholar) to identify the randomized controlled trials (RCTs) that evaluated the BP-lowering effect of PCs. Subgroup and sensitivity analyses were conducted to evaluate the potential heterogeneity. Meta-regression analysis was used to evaluate dose effects of PCs on BP. RESULTS A total of 6 studies comprising 376 subjects were included in our meta-analysis to estimate the pooled effect size. This meta-analysis suggested that PCs supplementation could significantly reduce systolic blood pressure (SBP) (WMD: -4.598 mmHg; 95 % CI: -8.037, -1.159; I2 = 33.7 %; p = 0.009), diastolic blood pressure (DBP) (WMD: -2.750 mmHg; 95 % CI: -5.087, -0.412; I2 = 0.0 %; p = 0.021) and mean arterial pressure (MAP) (WMD: -3.366 mmHg; 95 % CI: -6.719, -0.041 mmHg; I2 = 0.0 %; p = 0.049), but had no significant effect on pulse pressure (PP) (WMD: -2.131 mmHg; 95 % CI: -6.292, 2.030; I2 = 0.0 %; p = 0.315). When the studies were stratified according to the duration of the study, there was a significant reduction on SBP in the subset of the trials with <12 weeks of duration. On the contrary, there was a significant reduction on DBP in the subset of the trials with ≥12 weeks of duration. The Subgroup analysis by BMI indicated that a significant reduction on SBP for people with a higher BMI (BMI ≥ 25) and a significant reduction on DBP for people with a lower BMI (BMI < 25). Additional subgroup analysis revealed low-dose-PCs (<245 mg/day) could significantly reduce SBP, DBP and MAP. The meta-regression analyses did not indicate the dose effects of PCs on SBP, DBP, PP and MAP. CONCLUSION Based on the current findings, PCs supplementation may be a useful treatment of hypertensive patients as well as a preventive measure in the prehypertensive and healthy subjects. However, further investigation is needed to confirm these results.
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Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis.
Mattioni Maturana, F, Martus, P, Zipfel, S, NIEß, AM
Medicine and science in sports and exercise. 2021;(3):559-573
Abstract
PURPOSE We aimed to investigate differences between high-intensity interval exercise (HIIE, including high-intensity interval training and sprint interval training) and moderate-intensity continuous training (MICT) on physical fitness, body composition, blood pressure, blood lipids, insulin and glucose metabolism, inflammation, and endothelial function. METHODS Differences between HIIE and MICT were summarized using a random-effects meta-analysis on the effect size (Cohen's d). A meta-regression was conducted using the following subgroups: population, age, training duration, men ratio, exercise type, baseline values (clinical relevant ranges), and type of HIIE. Studies were included if at least one of the following outcomes were reported: maximal oxygen uptake (V˙O2max), flow-mediated dilation (FMD), body mass index (BMI), body mass, percent body fat, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, total cholesterol, C-reactive protein (CRP), fasting glucose and insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR). A total of 55 studies were included. RESULTS Overall, HIIE was superior to MICT in improving V˙O2max (d = 0.40, P < 0.001) and FMD (d = 0.54, P < 0.05). Oppositely, MICT was superior to HIIE in improving HbA1c (d = -0.27, P < 0.05). No differences were observed in BMI (d = -0.02), body mass (d = -0.05), percent body fat (d = 0.04), systolic blood pressure (d = -0.04), diastolic blood pressure (d = 0.03), HDL (d = -0.05), LDL (d = 0.08), triglycerides (d = 0.03), total cholesterol (d = 0.14), CRP (d = -0.11), fasting insulin (d = 0.02), fasting glucose (d = 0.02), and HOMA-IR (d = -0.04). Moderator analyses indicated that the difference between HIIE and MICT was affected by different subgroups. CONCLUSION Overall, HIIE showed to be more effective in improving cardiovascular health and cardiorespiratory fitness, whereas MICT was superior in improving long-term glucose metabolism. In the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.
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Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis.
Wu, Y, Johnson, BT, Chen, S, Chen, Y, Livingston, J, Pescatello, LS
Journal of sport and health science. 2021;(2):211-221
Abstract
BACKGROUND Professional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy. METHODS Tai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions. RESULTS Participants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (-11.3 mmHg, 95%CI: -14.6 to -8.0; d+ = -0.75) and DBP (-4.8 mmHg, 95%CI: -6.4 to -3.1; d+ = -0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg). CONCLUSION Our results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%.