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Complementary Therapies in Clinical... Nov 2023Depression is becoming more prevalent in older adults. Music therapy appears to have a positive effect on older adults with depression, but the effects of specific... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Depression is becoming more prevalent in older adults. Music therapy appears to have a positive effect on older adults with depression, but the effects of specific interventions (such as active music therapy and passive music therapy) are not fully known. This review aims to evaluate the therapeutic effects of music therapy and the effects of specific interventions on older adults with depression.
METHODS
A systematic search was conducted from inception to June 2022, and an updated search was conducted in July 2023 on PubMed, Web of Science, Cochrane Library, Embase, VIP, Wanfang Data, CNKI, and CBM. This review solely targeted randomized controlled trials. Two reviewers independently reviewed the retrieved studies. The risk of bias was evaluated using the Cochrane risk of bias assessment tool 2.0, and statistical analysis was made using the RevMan 5.4 software.
RESULTS
Twenty-one studies with a total of 1777 participants were included. Music therapy was beneficial in reducing depression, anxiety, and blood pressure and increasing cognitive ability (p < 0.05). Subgroup analysis showed that passive music therapy, single intervention for 60 min, individual intervention format, and total duration of 20 h had a more significant effect on depressive symptoms in older adults.
CONCLUSION
Music therapy reduces symptoms of depression and anxiety, improves blood pressure, and enhances cognitive ability in older adults with depression. Further rigorously designed studies are warranted to confirm the effects of music therapy on older adults with depression.
Topics: Humans; Aged; Music Therapy; Depression; Anxiety; Anxiety Disorders; Blood Pressure; Music
PubMed: 37952258
DOI: 10.1016/j.ctcp.2023.101809 -
Aging Clinical and Experimental Research Apr 2023The objective of this systematic review and meta-analysis is to investigate whether nocturnal blood pressure fall, expressed by dipping patterns according to 24 h... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review and meta-analysis is to investigate whether nocturnal blood pressure fall, expressed by dipping patterns according to 24 h ambulatory blood pressure monitoring (ABPM), is associated with abnormal cognitive function (cognitive impairment or dementia).
METHODS
We systematically searched PubMed, Embase, and Cochrane databases to identify original articles through December 2022. We included any study with at least ten participants reporting on all-cause dementia or cognitive impairment incidence (primary outcome) or validated cognitive tests (secondary outcome) among ABPM patterns. We assessed risk of bias using Newcastle-Ottawa Quality Assessment Scale. We pooled odds ratios (OR) and standardized mean differences (SMD) using random-effect models for primary and secondary outcome, respectively.
RESULTS
In the qualitative synthesis, 28 studies examining 7595 patients were included. The pooled analysis of 18 studies showed that dippers had a 51% [OR 0.49(0.35-0.69)] lower risk of abnormal cognitive function and a 63% [OR 0.37(0.23-0.61)] lower risk of dementia alone, compared to non-dippers. Reverse dippers presented an up to sixfold higher risk [OR 6.06(3.15-11.64)] of abnormal cognitive function compared to dippers and an almost twofold higher risk [OR 1.81(1.26-2.6)] compared to non-dippers. Reverse dippers performed worse in global function neuropsychological tests compared with both dippers [SMD - 0.66(- 0.93 to - 0.39)] and non-dippers [SMD - 0.35(- 0.53 to - 0.16)].
CONCLUSION
Dysregulation of the normal circadian BP rhythm, specifically non-dipping and reverse dipping is associated with abnormal cognitive function. Further studies are required to determine potential underlying mechanisms and possible prognostic or therapeutic implications.
PROTOCOL REGISTRATION
PROSPERO database (ID: CRD42022310384).
Topics: Humans; Hypertension; Blood Pressure Monitoring, Ambulatory; Blood Pressure; Cognition; Dementia; Circadian Rhythm
PubMed: 36995461
DOI: 10.1007/s40520-023-02361-7 -
Nutrition, Metabolism, and... Sep 2022The aim of this meta-review was to establish the effects of green tea (GT) intake on some cardiometabolic risk factors including anthropometric measures, blood pressure... (Meta-Analysis)
Meta-Analysis
A comprehensive overview on the effects of green tea on anthropometric measures, blood pressure, glycemic and lipidemic status: An umbrella review and meta meta-analysis study.
AIM
The aim of this meta-review was to establish the effects of green tea (GT) intake on some cardiometabolic risk factors including anthropometric measures, blood pressure as well as blood glucose and lipids using evidence from previous systematic reviews and meta-analyses.
DATA SYNTHESIS
Articles were identified via searches in PubMed, Embase, and the Cochrane Library, Web of Knowledge database from the index date of each database through January 31, 2021. A total of 13 meta-analyses were finally included in the synthesis. Meta-meta-analysis revealed significant effects of GT on weight and waist circumference with weighted mean difference (WMD) of -0.89 (95% CI -1.43 to -0.34, p < 0.001) and -1.01 (95% CI -1.63 to -0.39, p < 0.001), systolic and diastolic blood pressure, with WMDs of -1.17 (95% CI -2.18 to -0.16) and -1.24 (95% CI -2.07 to -0.4), respectively. There was similar effect on fasting blood glucose (WMD, -1.3, 95% CI -2.09 to -0.51, p < 0.001) but not on other glycemic indicators. The findings also revealed a significant effect size of total cholesterol and LDL-C (WMD -4.93; 95% CI -6.41 to -3.46, p < 0.001, WMD -4.31; 95% CI -6.55 to -2.07, p < 0.001, respectively).
CONCLUSION
Regular consumption of GT and probably its bioactive constituents as supplements have beneficial effects on different health aspects including weight, blood pressure, blood glucose and lipids. However, these effects might be influenced by several factors such as the amount and frequency of consumption, health/disease condition and life style including dietary habits and physical activity.
Topics: Blood Glucose; Blood Pressure; Body Weight; Dietary Supplements; Humans; Life Style; Lipids; Tea; Waist Circumference
PubMed: 35750605
DOI: 10.1016/j.numecd.2022.05.021 -
Diabetes & Metabolic Syndrome Jun 2023Currently, there is uncertainty as to whether blood pressure control in patients with type 2 diabetes should be treated to standard recommended levels or more... (Meta-Analysis)
Meta-Analysis
Effect of more versus less intensive blood pressure control on cardiovascular, renal and mortality outcomes in people with type 2 diabetes: A systematic review and meta-analysis.
BACKGROUND AND AIMS
Currently, there is uncertainty as to whether blood pressure control in patients with type 2 diabetes should be treated to standard recommended levels or more intensively.
METHODS
Medline, EMBASE, CENTRAL, and Clinicaltrials.gov were searched between January 1, 2000 and April 20th, 2023. Outcomes considered were all-cause mortality, stroke, heart failure, cardiovascular disease, albuminuria, coronary heart disease, and renal outcomes. Random-effects meta-analyses estimated pooled relative risks and mean differences.
RESULTS
Nine trials enrolling 11,005 participants with type 2 diabetes were included. The pooled mean difference between the intensive and standard treatment groups at follow-up were -7.98 mmHg (95% CI: 12.19 to -3.76) in systolic blood pressure, and -5.08 mmHg (-7.00 to -3.17) in diastolic blood pressure; although between study heterogeneity was high for both meta-analyses (I>85%). Intensive blood pressure lowering resulted in a reduction in risk of stroke (risk ratio 0.64; 0.52 to 0.79), and macro-albuminuria (0.77; 0.63 to 0.93). More intensive blood pressure control did not result in a statistically significant reduction in risk of all-cause mortality, heart failure, cardiovascular death, cardiovascular events, renal outcomes, and micro-albuminuria; although the direction of estimated effect was beneficial for all outcomes.
CONCLUSIONS
The use of intensive compared with standard blood pressure targets resulted in a significant reduction in blood pressure, stroke, and macro-albuminuria in patients with type 2 diabetes. The post-treatment blood pressure level in the intensive group was 125/73 mmHg, suggesting the current recommendations of 130/80 mmHg blood pressure or lower if tolerated, could be reduced further.
Topics: Humans; Blood Pressure; Diabetes Mellitus, Type 2; Albuminuria; Antihypertensive Agents; Cardiovascular Diseases; Stroke; Heart Failure; Hypertension
PubMed: 37257222
DOI: 10.1016/j.dsx.2023.102782 -
Blood Pressure Monitoring Dec 2023Strict blood pressure control is essential to prevent cardiovascular disease and is associated with decreased mortality. However, in patients with end-stage renal... (Review)
Review
BACKGROUND
Strict blood pressure control is essential to prevent cardiovascular disease and is associated with decreased mortality. However, in patients with end-stage renal disease awaiting renal transplantation, the level of optimal blood pressure control is not yet defined.
METHODS
Following the PRISMA Extension for Scoping Reviews, we searched MEDLINE and EMBASE for all peer-reviewed articles using keywords including 'end-stage renal disease', 'blood pressure', and 'pre-transplant' from their inception to 7 August 2022.
RESULTS
Seven observational studies, including one population-based study, were included in the review. Most studies investigated factors associated with post-transplant graft failure or mortality. There was considerable heterogeneity in defining optimal pre-transplant blood pressure measurement frequency among studies (average of three measurements vs. single measurement). One study suggested that low pre-transplant diastolic blood pressure (<50 mmHg) was associated with lower odds of delayed graft failure and mortality. Two studies noted that pre-transplant hypertension, or clinical criteria of hypertension that were present prior to transplant, was associated with post-transplant adverse outcomes. In contrast, one study noted that pre-transplant sustained hypotension with mean blood pressure <80 mmHg, was associated with a higher frequency of delayed graft failure.
CONCLUSION
This systematic review summarizes the current evidence regarding the relationship between pre-transplant blood pressure control and post-transplant outcomes in end-stage renal disease patients. While the results from the included studies are mixed, more stringent blood pressure control than currently practiced may be beneficial to decrease graft failure and mortality in this patient population.
Topics: Humans; Blood Pressure; Hypotension; Hypertension; Kidney Failure, Chronic; Prehypertension
PubMed: 37910025
DOI: 10.1097/MBP.0000000000000668 -
The Lancet. Global Health Aug 2023More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income... (Meta-Analysis)
Meta-Analysis
BACKGROUND
More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948).
FINDINGS
We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, p<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; p<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; p<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; p<0·0001).
INTERPRETATION
To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region.
FUNDING
None.
Topics: Adult; Humans; Male; Adolescent; Female; Young Adult; Blood Pressure; Africa South of the Sahara; Hypertension; Prevalence; Qualitative Research
PubMed: 37474231
DOI: 10.1016/S2214-109X(23)00218-8 -
Current Hypertension Reports Jul 2024Pregnancy-induced preeclampsia is a severe pregnancy complication and preeclampsia has been associated with an increased risk of chronic hypertension for offspring.... (Meta-Analysis)
Meta-Analysis Review
PURPOSE OF REVIEW
Pregnancy-induced preeclampsia is a severe pregnancy complication and preeclampsia has been associated with an increased risk of chronic hypertension for offspring. However, the magnitude of the overall effect of exposure to preeclampsia in pregnancy on blood pressure (BP) in offspring is unknown. This systematic review and meta-analysis was sought to systematically assess the effects of preeclampsia on the BP of the offspring.
RECENT FINDINGS
Of 2550 publications identified, 23 studies were included. The meta-analysis indicated that preeclampsia increases the potential risk of hypertension in offspring. Systolic blood pressure (SBP) was 2.0 mm Hg (95% CI: 1.2, 2.8) and diastolic blood pressure (DBP) was 1.4 mm Hg (95% CI: 0.9, 1.9) higher in offspring exposed to pre-eclampsia in utero, compared to those born to normotensive mothers. The correlations were similar in stratified analyses of children and adolescents by sex, geographic area, ages, and gestational age. During childhood and young adulthood, the offspring of pregnant women with preeclampsia are at an increased risk of high BP. It is crucial to monitor their BP.
Topics: Humans; Pregnancy; Pre-Eclampsia; Female; Blood Pressure; Hypertension; Prenatal Exposure Delayed Effects; Risk Factors
PubMed: 38780756
DOI: 10.1007/s11906-024-01306-3 -
Diabetes & Metabolic Syndrome Feb 2022The present systematic review and meta-analysis aimed to summarize the findings of randomized controlled trials (RCTs) evaluating the effect of tart and sweet cherries... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
The present systematic review and meta-analysis aimed to summarize the findings of randomized controlled trials (RCTs) evaluating the effect of tart and sweet cherries on systolic and diastolic blood pressure (SBP and DBP).
METHODS
PubMed, Scopus, Embase, and Web of Science were searched to acquire the RCTs up to December 2020.
RESULTS
Seven RCTs comprising 201 participants were included. The meta-analysis showed that cherry supplementation does not lead to a significant decrease in SBP or DBP.
CONCLUSIONS
Incorporating cherries into the diet has no significant effect on blood pressure.
Topics: Blood Pressure; Diet; Dietary Supplements; Humans; Hypertension; Randomized Controlled Trials as Topic
PubMed: 35108661
DOI: 10.1016/j.dsx.2022.102409 -
Menopause (New York, N.Y.) Aug 2022Cardiovascular disease (CVD) is a leading cause of morbidity and mortality for menopausal individuals. Flow-mediated dilation (FMD), a surrogate marker of CVD, improves... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality for menopausal individuals. Flow-mediated dilation (FMD), a surrogate marker of CVD, improves with aerobic exercise training in healthy and nonhealthy cohorts. However, systematic evaluation and precise estimate of this effect for menopausal individuals are unknown.
OBJECTIVE
We conducted a systematic review with meta-analysis to evaluate the influence of exercise training on FMD in postmenopausal individuals.
EVIDENCE REVIEW
Studies were identified from systematic search of major electronic databases (PubMed, ScienceDirect, and Cochrane Library) from inception to February 2021. Healthy, postmenopausal individuals were included, following an aerobic exercise intervention assessing FMD. A random-effects meta-analysis was used to calculate a pooled effect size (mean difference [MD]) with 95% confidence interval. Heterogeneity was assessed using I2 statistics. Metaregression was used to assess the association between changes in FMD and physical characteristics (eg, blood pressure, age, baseline FMD) and intervention details (metabolic equivalents and change in maximal oxygen uptake [∆V˙ o2max ]). For variables that significantly correlated, a multiple metaregression model was used to assess the accounted variance in between-study ∆FMD%. Study quality was assessed using the National Heart, Lung, and Blood Institute assessment tool.
FINDINGS
Nine studies, including 11 interventions (6 controlled interventions and 5 pre-post interventions; N = 182), with age range of 52 ± 4 to 64 ± 7 years underwent quantitative pooling of data. Exercise training significantly improved ∆FMD% (MD, 0.99; 95% confidence interval, 0.46-1.52; P < 0.001). Between-study heterogeneity was large and statistically significant ( I2 = 93.8%, P < 0.001). Post hoc analysis based on study design identified significant heterogeneity in the MD in ∆FMD% between controlled and pre-post study interventions ( P < 0.05). According to multiple metaregression, diastolic and systolic blood pressure and ∆V˙ o2max significantly predicted ∆FMD% ( Q = 15.74, df = 3, P < 0.01, R2 = 0.72).
CONCLUSIONS AND RELEVANCE
Aerobic exercise training improves FMD for postmenopausal individuals, and this observation was greater among controlled versus pre-post interventions. A higher resting blood pressure and the greatest ∆V˙ o2max yielded the largest improvements in FMD.
Topics: Blood Pressure; Cardiovascular Diseases; Exercise; Exercise Therapy; Humans; Hypertension; Postmenopause
PubMed: 35881939
DOI: 10.1097/GME.0000000000002000 -
European Journal of Clinical Nutrition Oct 2021This paper aimed to systematically review the results of observational studies that investigated the association of dietary patterns with blood pressure and body... (Review)
Review
This paper aimed to systematically review the results of observational studies that investigated the association of dietary patterns with blood pressure and body adiposity markers in adolescents. Articles were searched in July 2020 in PubMed, Scopus, Web of Science, and Scientific Electronic Library Online (SciELO). Of the 3408 studies found, 24 fulfilled the inclusion criteria and were considered in this review. Almost all studies (n = 23) identified at least one unhealthy pattern, predominantly characterized as consumption of confectionery, refined grains, sweets, sweetened drinks, red meats, and processed meats. Fourteen of the twenty-four studies found a significant association between any dietary pattern and blood pressure and/or body adiposity markers. There was a positive association of dietary patterns - characterized by the consumption of foods rich in sodium, animal fat, refined carbohydrates, and low in fiber - with increased blood pressure and body adiposity. Our findings highlight the importance of studies with this scope, whose results can support the surveillance of adolescent's health. However, considering the limited number of studies that found a significant association and their limitations, the present results should be interpreted carefully. More prospective studies are needed to determine how adherence to dietary patterns could influence blood pressure and body adiposity markers in the long term.
Topics: Adiposity; Adolescent; Blood Pressure; Diet; Feeding Behavior; Humans; Obesity; Prospective Studies
PubMed: 33531634
DOI: 10.1038/s41430-020-00850-w