Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis
Pairwise meta-analyses have shown beneficial effects of individual dietary approaches on blood pressure but their comparative effects have not been established. Objective: Therefore we performed a systematic review of different dietary intervention trials and estimated the aggregate blood pressure...
| Main Authors: | , , , , , , |
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| Format: | info:eu-repo/semantics/article |
| Language: | eng |
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Taylor&Francis
2021
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| Online Access: | https://hdl.handle.net/10171/62170 |
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| author | Schwingshackl, L. (Lukas) Chaimani, A. (Anna) Schwedhelm, C. (Carolina) Toledo, E. (Estefanía) Pünsch, M. (Marina) Hoffmann, G. (Georg) Boeing, H. (Heiner) |
| author_facet | Schwingshackl, L. (Lukas) Chaimani, A. (Anna) Schwedhelm, C. (Carolina) Toledo, E. (Estefanía) Pünsch, M. (Marina) Hoffmann, G. (Georg) Boeing, H. (Heiner) |
| author_sort | Schwingshackl, L. (Lukas) |
| collection | DSpace |
| description | Pairwise meta-analyses have shown beneficial effects of individual dietary approaches on blood
pressure but their comparative effects have not been established. Objective: 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. Design: 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. Results: A total of 67 trials comparing 13 dietary approaches (DASH, lowfat, 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 metaanalysis, the DASH, Mediterranean, low-carbohydrate, Palaeolithic, high-protein, low-glycaemic index, lowsodium, 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. Conclusion: The present network meta-analysis suggests that the DASH dietary approach might be the most effective dietary measure toreduce blood pressure among hypertensive and pre-hypertensive patients based on high quality evidence. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-62170 |
| institution | Universidad de Navarra |
| language | eng |
| publishDate | 2021 |
| publisher | Taylor&Francis |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-621702021-10-20T01:04:48Z Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis Schwingshackl, L. (Lukas) Chaimani, A. (Anna) Schwedhelm, C. (Carolina) Toledo, E. (Estefanía) Pünsch, M. (Marina) Hoffmann, G. (Georg) Boeing, H. (Heiner) Dietary approaches Hypertension Network metaanalysis Blood pressure Evidence synthesis Pairwise meta-analyses have shown beneficial effects of individual dietary approaches on blood pressure but their comparative effects have not been established. Objective: 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. Design: 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. Results: A total of 67 trials comparing 13 dietary approaches (DASH, lowfat, 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 metaanalysis, the DASH, Mediterranean, low-carbohydrate, Palaeolithic, high-protein, low-glycaemic index, lowsodium, 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. Conclusion: The present network meta-analysis suggests that the DASH dietary approach might be the most effective dietary measure toreduce blood pressure among hypertensive and pre-hypertensive patients based on high quality evidence. 2021-10-19T08:27:45Z 2021-10-19T08:27:45Z 2018 info:eu-repo/semantics/article https://hdl.handle.net/10171/62170 eng info:eu-repo/semantics/openAccess application/pdf Taylor&Francis |
| spellingShingle | Dietary approaches Hypertension Network metaanalysis Blood pressure Evidence synthesis Schwingshackl, L. (Lukas) Chaimani, A. (Anna) Schwedhelm, C. (Carolina) Toledo, E. (Estefanía) Pünsch, M. (Marina) Hoffmann, G. (Georg) Boeing, H. (Heiner) Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title | Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title_full | Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title_fullStr | Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title_full_unstemmed | Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title_short | Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis |
| title_sort | comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: a systematic review and network meta-analysis |
| topic | Dietary approaches Hypertension Network metaanalysis Blood pressure Evidence synthesis |
| url | https://hdl.handle.net/10171/62170 |
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