The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies
Ghadeer S. Aljuraiban , Rachel Gibson , Doris SM. Chan , Linda Van Horn , Queenie Chan
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引用次数: 0
Abstract
High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.
高血压(BP)是多种心血管疾病发展的主要病理危险因素。饮食是血压的一个关键调节因素,但其潜在关系尚未得到明确证明。这是对已发表的荟萃分析的全面综述,旨在批判性地评估从生物活性化合物到饮食模式对血压和高血压风险的广泛饮食证据。从开始到2021年10月31日,PubMed、Embase、Web of Science和Cochrane对照试验中央注册中心都在搜索随机对照试验的相关荟萃分析或观察性研究的荟萃分析。共有175篇出版物报告了341篇随机对照试验的荟萃分析(145篇出版物)和70篇观察性研究的荟萃分析。纳入出版物的方法学质量使用多系统评价2(AMSTAR 2)进行评估,每个选定荟萃分析的证据质量使用NutriGrade进行评估。这项总括性审查支持推荐的预防和控制高血压的公共卫生指南。建议采用饮食模式,包括停止高血压的饮食方法(DASH)和进一步限制钠和适度饮酒的地中海式饮食。为了提供高质量的证据并证实强有力的建议,未来的研究应解决证据质量低的领域(如膳食纤维、鱼类、鸡蛋、肉类、乳制品、果汁和坚果的摄入),并强调关注尚未最终调查的饮食因素。
期刊介绍:
Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments.
In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.