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Experimental Gerontology Feb 2022The current systematic review and meta-analysis evaluated the effects of High-Intensity Interval Training (HIIT) on blood pressure (BP) in older adults and compared the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/OBJECTIVES
The current systematic review and meta-analysis evaluated the effects of High-Intensity Interval Training (HIIT) on blood pressure (BP) in older adults and compared the efficacy of HIIT versus moderate-intensity continuous training (MICT).
METHODS
Search was conducted using the databases at PubMed, Scopus, Cochrane Library and EMBASE, for randomized trials comparing the chronic effects (≥4 weeks) of HIIT versus MICT or control group (non-exercise) on BP in older adults (≥60 years) with or without hypertension.
RESULTS
A total of 10 articles (n = 266 participants) were included in this meta-analysis. HIIT were associated with reductions in systolic BP (MD -7.36; 95%CI -11.80 to -2.92; P < 0.01; I = 24%) and diastolic BP (MD -5.48; 95%CI -8.71 to -2.25; P < 0.01; I = 40%) versus control group. No differences were found between HIIT and MICT in systolic BP (MD -2.09; 95%CI -9.76 to 5.58; P = 0.59; I = 0%) and diastolic BP (MD -1.00; 95%CI -6.01 to 4.01; P = 0.69; I = 0%).
CONCLUSION
HIIT reduces BP in older adults. Additionally, HIIT and MICT provided comparable reductions on BP in this population.
Topics: Aged; Blood Pressure; Exercise; High-Intensity Interval Training; Humans; Hypertension
PubMed: 34921916
DOI: 10.1016/j.exger.2021.111657 -
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 -
Journal of Human Hypertension Aug 2007The aim of this study was to assess whether the pulse pressures (PPs) in people of African and South Asian descent differ from those of the European-origin White... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to assess whether the pulse pressures (PPs) in people of African and South Asian descent differ from those of the European-origin White (henceforth, White) in the UK. A systematic literature review was carried out using MEDLINE 1966-2006 and EMBASE 1980-2006. The meta-analysis was performed using Cochrane review manager software (RevMan version 4.2; Oxford, UK). Thirteen studies were examined. Results for African descent men (n=9 studies) and women (n=7) indicated that African men and women had a higher mean PP than their White counterparts. Overall weighted mean difference (WMD) in PP was 1.68 (95% confidence interval: [0.38, 2.98 mm Hg]; P=0.01) in men and 2.01 ([0.39, 3.63 mm Hg]; P<0.001) in women. South Asian men (n=7 studies) had a lower mean PP than White men (-1.94; [-3.56, -0.32 mm Hg]; P=0.02), whereas no significant difference was found between South Asian and White women (n=5 studies) (-0.40; [-3.22, 2.39 mm Hg]; P=0.77). Separate data were available for Indians (n=5 studies), Bangladeshis (n=4) and Pakistanis (n=3). Bangladeshis had a lower PP than Whites (men, -5.61; [-6.87, -4.36 mm Hg]; P<0.001) (women, -5.21; [-8.67, -1.75 mm Hg]; P=0.003). Pakistani men had a lower PP than White men (-3.33 mm Hg; [-5.67, -1.00]; P<0.001). The WMD was nonsignificantly lower in Indian men (-0.76 mm Hg), Indian women (-0.80 mm Hg) and Pakistani women (-2.06 mm Hg). The higher PP found among African descent people may contribute to their more frequent hypertension complications. However, the lower PP in South Asian populations, particularly in Bangladeshis and Pakistani men, indicates that PP is unlikely to contribute to their higher risk of cardiovascular disease in the UK.
Topics: Asian People; Black People; Blood Pressure; Female; Humans; Hypertension; Male; White People
PubMed: 17380151
DOI: 10.1038/sj.jhh.1002191 -
British Journal of Sports Medicine Jul 2019To compare the effect of exercise regimens and medications on systolic blood pressure (SBP). (Meta-Analysis)
Meta-Analysis
How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure.
OBJECTIVE
To compare the effect of exercise regimens and medications on systolic blood pressure (SBP).
DATA SOURCES
Medline (via PubMed) and the Cochrane Library.
ELIGIBILITY CRITERIA
Randomised controlled trials (RCTs) of angiotensin-converting enzyme inhibitors (ACE-I), angiotensin-2 receptor blockers (ARBs), β-blockers, calcium channel blockers (CCBs) and diuretics were identified from existing Cochrane reviews. A previously published meta-analysis of exercise interventions was updated to identify recent RCTs that tested the SBP-lowering effects of endurance, dynamic resistance, isometric resistance, and combined endurance and resistance exercise interventions (up to September 2018).
DESIGN
Random-effects network meta-analysis.
OUTCOME
Difference in mean change from baseline SBP between comparator treatments (change from baseline in one group minus that in the other group) and its 95% credible interval (95% CrI), measured in mmHg.
RESULTS
We included a total of 391 RCTs, 197 of which evaluated exercise interventions (10 461 participants) and 194 evaluated antihypertensive medications (29 281 participants). No RCTs compared directly exercise against medications. While all medication trials included hypertensive populations, only 56 exercise trials included hypertensive participants (≥140 mmHg), corresponding to 3508 individuals. In a 10% random sample, risk of bias was higher in exercise RCTs, primarily due to lack of blinding and incomplete outcome data. In analyses that combined all populations, antihypertensive medications achieved higher reductions in baseline SBP compared with exercise interventions (mean difference -3.96 mmHg, 95% CrI -5.02 to -2.91). Compared with control, all types of exercise (including combination of endurance and resistance) and all classes of antihypertensive medications were effective in lowering baseline SBP. Among hypertensive populations, there were no detectable differences in the SBP-lowering effects of ACE-I, ARB, β-blocker and diuretic medications when compared with endurance or dynamic resistance exercise. There was no detectable inconsistency between direct and indirect comparisons. Although there was evidence of small-study effects, this affected both medication and exercise trials.
CONCLUSIONS
The effect of exercise interventions on SBP remains under-studied, especially among hypertensive populations. Our findings confirm modest but consistent reductions in SBP in many studied exercise interventions across all populations but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens. Assuming equally reliable estimates, the SBP-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. Generalisability of these findings to real-world clinical settings should be further evaluated.
Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Blood Pressure; Calcium Channel Blockers; Diuretics; Exercise; Humans; Hypertension; Network Meta-Analysis
PubMed: 30563873
DOI: 10.1136/bjsports-2018-099921 -
PloS One Aug 2010Elevated blood pressure (BP), which is a major risk factor for cardiovascular disease, is highly prevalent worldwide. Recently, interest has grown in the role of dietary... (Review)
Review
BACKGROUND
Elevated blood pressure (BP), which is a major risk factor for cardiovascular disease, is highly prevalent worldwide. Recently, interest has grown in the role of dietary protein in human BP. We performed a systematic review of all published scientific literature on dietary protein, including protein from various sources, in relation to human BP.
METHODOLOGY/PRINCIPAL FINDINGS
We performed a MEDLINE search and a manual search to identify English language studies on the association between protein and blood pressure, published before June 2010. A total of 46 papers met the inclusion criteria. Most observational studies showed no association or an inverse association between total dietary protein and BP or incident hypertension. Results of biomarker studies and randomized controlled trials indicated a beneficial effect of protein on BP. This beneficial effect may be mainly driven by plant protein, according to results in observational studies. Data on protein from specific sources (e.g. from fish, dairy, grain, soy, and nut) were scarce. There was some evidence that BP in people with elevated BP and/or older age could be more sensitive to dietary protein.
CONCLUSIONS/SIGNIFICANCE
In conclusion, evidence suggests a small beneficial effect of protein on BP, especially for plant protein. A blood pressure lowering effect of protein may have important public health implications. However, this warrants further investigation in randomized controlled trials. Furthermore, more data are needed on protein from specific sources in relation to BP, and on the protein-BP relation in population subgroups.
Topics: Animals; Biomarkers; Blood Pressure; Clinical Trials as Topic; Dietary Proteins; Humans; Plant Proteins; Species Specificity
PubMed: 20711407
DOI: 10.1371/journal.pone.0012102 -
Anaesthesiology Intensive Therapy 2022Mean arterial pressure (MAP) is a key haemodynamic variable monitored in critically ill patients. The advantages of oscillometric noninvasive blood pressure (NIBP)... (Meta-Analysis)
Meta-Analysis Review
Mean arterial pressure (MAP) is a key haemodynamic variable monitored in critically ill patients. The advantages of oscillometric noninvasive blood pressure (NIBP) measurement are its easy and fast methodology; however, the accuracy and the precision of this measurement in critically ill patients is constantly debated. We performed a systematic review and meta-analysis of observational studies comparing oscillometric NIBP methods with invasive arterial pressure (IAP) measurements. We included studies of adult critically ill patients, which evaluated MAP in the same patient by both NIBP and IAP at any site. We included only studies comparing simultaneous measurements of arterial pressure by NIBP and IAP, reporting their results using mean difference and SD of agreement. The main outcome was to define the bias of the MAP measured by NIBP over the IAP measurement. The quality of the studies was analysed by the QUADAS 2 tool. Seven studies and 1593 patients were included in the main analysis. The oscillometric NIBP method had a mean value of -1.50 mmHg when compared with IAP (95% CI: -3.34 to 0.35; I2 = 96% for random effects model, P < 0.01). The limits of agreement for MAP varied between -14.6 mmHg and +40.3 mmHg. NIBP had an adequate accuracy regarding MAP measurements by oscillometry. Limits of agreement may thus narrow the clinical applicability in scenarios in which there is a need for a more precise management of blood pressure.
Topics: Adult; Humans; Blood Pressure; Blood Pressure Determination; Oscillometry; Critical Illness; Arterial Pressure
PubMed: 36734453
DOI: 10.5114/ait.2022.123120 -
Journal of Sport and Health Science Sep 2024High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to identify the most effective physical activity (PA) intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.
METHODS
A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study. Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent investigators performed the literature screening, data extraction, and risk of bias assessment. We used Bayesian arm-based NMA to synthesize the data. The primary outcomes were systolic BP and diastolic BP. We calculated the mean differences (MDs) in systolic BP and diastolic BP before and after treatment. Mean treatment differences were estimated using NMA and random-effect models.
RESULTS
We synthesized 27 studies involving 15,220 children and adolescents. PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP (MD = -8.64, 95% credible interval (95%CI):-11.44 to -5.84; MD = -6.75, 95%CI: -10.44 to -3.11), followed by interventions with multiple components (MD = -1.39, 95%CI: -1.94 to -0.84; MD = -2.54, 95%CI: -4.89 to -0.29).
CONCLUSION
Our findings suggest that PA interventions incorporating nutrition and behavior change, followed by interventions with multiple components, are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
Topics: Humans; Child; Blood Pressure; Exercise; Hypertension; Adolescent; Network Meta-Analysis
PubMed: 38244922
DOI: 10.1016/j.jshs.2024.01.004 -
BMC Complementary and Alternative... Aug 2017Shinrin-yoku (experiencing the forest atmosphere or forest bathing) has received increasing attention from the perspective of preventive medicine in recent years. Some... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Shinrin-yoku (experiencing the forest atmosphere or forest bathing) has received increasing attention from the perspective of preventive medicine in recent years. Some studies have reported that the forest environment decreases blood pressure. However, little is known about the possibility of anti-hypertensive applications of Shinrin-yoku. This study aimed to evaluate preventive or therapeutic effects of the forest environment on blood pressure.
METHODS
We systematically reviewed the medical literature and performed a meta-analysis.Four electronic databases were systematically searched for the period before May 2016 with language restriction of English and Japanese. The review considered all published, randomized, controlled trials, cohort studies, and comparative studies that evaluated the effects of the forest environment on changes in systolic blood pressure. A subsequent meta-analysis was performed.
RESULTS
Twenty trials involving 732 participants were reviewed. Systolic blood pressure of the forest environment was significantly lower than that of the non-forest environment. Additionally, diastolic blood pressure of the forest environment was significantly lower than that of the non-forest environment.
CONCLUSIONS
This systematic review shows a significant effect of Shinrin-yoku on reduction of blood pressure.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Blood Pressure; Female; Forests; Humans; Hypertension; Male; Middle Aged; Mind-Body Therapies; Trees; Walking; Young Adult
PubMed: 28814305
DOI: 10.1186/s12906-017-1912-z -
Arquivos Brasileiros de Cardiologia Apr 2014High blood pressure is the major risk factor for cardiovascular disease. Low blood pressure control rates in Latin American populations emphasize the need for gathering... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
High blood pressure is the major risk factor for cardiovascular disease. Low blood pressure control rates in Latin American populations emphasize the need for gathering evidence on effective therapies.
OBJECTIVE
To evaluate the effects of dietary interventions on blood pressure in Latin American populations.
METHODS
Systematic review. Electronic databases (MEDLINE/PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS and VHL) were searched and manual search for studies published up to April 2013 was performed. Parallel studies about dietary interventions in Latin American adult populations assessing arterial blood pressure (mm Hg) before and after intervention were included.
RESULTS
Of the 405 studies identified, 10 randomized controlled trials were included and divided into 3 subgroups according to the proposed dietary intervention. There was a non-significant reduction in systolic blood pressure in the subgroups of mineral replacement (-4.82; 95% CI: -11.36 to 1.73) and complex pattern diets (-3.17; 95% CI: -7.62 to 1.28). Regarding diastolic blood pressure, except for the hyperproteic diet subgroup, all subgroups showed a significant reduction in blood pressure: -4.66 mmHg (95% CI: -9.21 to -0.12) and -4.55 mmHg (95% CI: -7.04 to -2.06) for mineral replacement and complex pattern diets, respectively.
CONCLUSION
Available evidence on the effects of dietary changes on blood pressure in Latin American populations indicates a homogeneous effect of those interventions, although not significant for systolic blood pressure. Samples were small and the quality of the studies was generally low. Larger studies are required to build robust evidence.
Topics: Adult; Aged; Blood Pressure; Cardiovascular Diseases; Diet Therapy; Female; Humans; Hypertension; Latin America; Male; Middle Aged; Randomized Controlled Trials as Topic; Risk Factors; Treatment Outcome; Young Adult
PubMed: 24676220
DOI: 10.5935/abc.20140037 -
American Journal of Hypertension Jan 2014Current guidelines recommend diet and lifestyle modifications for primary prevention and treatment of hypertension, but do not encourage dietary pulses specifically for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Current guidelines recommend diet and lifestyle modifications for primary prevention and treatment of hypertension, but do not encourage dietary pulses specifically for lowering blood pressure (BP). To quantify the effect of dietary pulse interventions on BP and provide evidence for their inclusion in dietary guidelines, a systematic review and meta-analysis of controlled feeding trials was conducted.
METHODS
MEDLINE, EMBASE, Cochrane Library, and CINAHL were each searched from inception through 5 May 2013. Human trials ≥3 weeks that reported data for systolic, diastolic, and/or mean arterial BPs were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias of included studies. Effect estimates were pooled using random effects models, and reported as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (χ(2) test) and quantified (I(2)).
RESULTS
Eight isocaloric trials (n = 554 participants with and without hypertension) were included in the analysis. Dietary pulses, exchanged isocalorically for other foods, significantly lowered systolic (MD = -2.25 mm Hg (95% CI, -4.22 to -0.28), P = 0.03) and mean arterial BP (MD = -0.75 mm Hg (95% CI, -1.44 to -0.06), P = 0.03), and diastolic BP non-significantly (MD = -0.71 mm Hg (95% CI, -1.74 to 0.31), P = 0.17). Heterogeneity was significant for all outcomes.
CONCLUSIONS
Dietary pulses significantly lowered BP in people with and without hypertension. Higher-quality large-scale trials are needed to support these findings.
CLINICAL TRIAL REGISTRATION
NCT01594567.
Topics: Blood Pressure; Chi-Square Distribution; Diet; Fabaceae; Humans; Hypertension; Primary Prevention; Risk Factors; Risk Reduction Behavior; Seeds; Time Factors; Treatment Outcome
PubMed: 24014659
DOI: 10.1093/ajh/hpt155