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 to reduce blood pressure among hypertensive and pre-hypertensive patients based on high quality evidence
ABSTRACT Background : 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 .
Comparison of single versus multiple lifestyle interventions: are the antihypertensive effects of exercise training and diet-induced weight loss additive?
Although aerobic exercise training and diet-induced weight loss each have been shown to individually lower elevated blood pressure ( BP ) , it is currently not known whether their combined use produces an additive antihypertensive effect . In this r and omized clinical trial we therefore compared the effect on resting BP of exercise training only and dietary modification only with that of exercise training plus dietary modification in 55 sedentary , overweight patients with high normal BP or stage 1 or 2 hypertension . After baseline testing , patients were r and omized to 1 of the following 3 interventions for 12 weeks : exercise training only ( aerobic exercise ; 30 to 45 minutes ; 3 to 5 days/week ; 60 % to 85 % of maximal heart rate ) , dietary modification only ( aim ed primarily at weight loss via restriction of energy intake and dietary fat ) , or exercise training plus dietary modification .  Forty-eight patients completed the study . In these patients , exercise training plus dietary modification elicited a greater reduction ( p < or = 0.001 ) in body weight ( -7.1 + /- 2.9 vs -1.0 + /- 1.8 kg ) than exercise training only , and a greater increase ( p < or = 0.05 ) in maximal oxygen uptake ( 4.3 + /- 2.6 vs 1.9 + /- 2.0 ml/kg/min ) versus dietary modification only . However , the reduction in BP with exercise training plus dietary modification ( -12.5 + /- 6.3/7.9 + /- 4.3 mm Hg ) did not differ significantly from that with exercise training only ( -9.9 + /- 6.4/5.9 + /- 4.6 mm Hg ) or dietary modification only ( -11.3 + /- 12.1/7.5 + /- 4.3 mm Hg ) . These data indicate that the antihypertensive effects of exercise training and diet-induced weight loss are not additive . This finding has important public health and clinical implication s for the millions of overweight persons with high normal BP or stage 1 or 2 hypertension
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 to reduce blood pressure among hypertensive and pre-hypertensive patients based on high quality evidence
ABSTRACT Background : 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 .