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 .
Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. The Trials of Hypertension Prevention Collaborative Research Group.
OBJECTIVE To provide a firmer basis for preventing high blood pressure ( BP ) , we tested interventions to promote weight loss , dietary sodium reduction , and their combination for lowering diastolic BP , systolic BP , and the incidence of hypertension during a 3- to 4-year period . METHODS We conducted a r and omized , 2 x 2 factorial , clinical trial , with BP levels measured by blinded observers . Nine academic medical centers recruited 2382 men and women ( age range , 30 - 54 years ) not taking antihypertensive drugs , with a diastolic BP of 83 to 89 mm Hg , a systolic BP lower than 140 mm Hg , and a body mass index ( the weight in kilograms divided by the square of the height in meters ) representing 110 % to 165 % of desirable body weight . Counseling aim ed at helping participants achieve their desirable weight or a 4.5-kg or more weight reduction ( in the weight loss and combined groups ) and /or sodium intake of 80 mmol/d ( in the sodium reduction and combined groups ) was provided . RESULTS From baseline , participants ' weight decreased by 4.3 to 4.5 kg at 6 months and by approximately 2 kg at 36 months in the weight loss and combined groups compared with weight changes in the usual care group ( all groups , P < .001 ) . Sodium excretion decreased 50 and 40 mmol/d at 6 and 36 months , respectively , in the sodium reduction group and about 15 mmol/d less at each time point in the combined group compared with the usual care group ( all groups , P < .01 ) . Compared with the usual care group , BP decreased 3.7/2.7 mm Hg in the weight loss group , 2.9/1.6 mm Hg in the sodium reduction group , and 4.0/2.8 mm Hg in the combined group at 6 months ( all groups , P < .001 ) . At 36 months , BP decreases remained greater in the active intervention groups than in the usual care group ( weight loss group , 1.3/0.9 mm Hg ; sodium reduction group , 1.2/0.7 mm Hg ; combined group , 1.1/0.6 mm Hg ) . Differences were statistically significant for systolic and diastolic BP in the weight loss group and for systolic BP in the sodium reduction group . Through 48 months , the incidence of hypertension ( BP > or = 140 mm Hg systolic or > or = 90 mm Hg diastolic or the use of antihypertensive drugs ) was significantly less in each active intervention group than the usual care group ( average relative risks , 0.78 - 0.82 ) . CONCLUSIONS In overweight adults with high-normal BP , weight loss and reduction in sodium intake , individually and in combination , were effective in lowering systolic and diastolic BP , especially in the short-term ( 6 months ) . Although the effects on average BP declined over time , reductions in hypertension incidence were achieved
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 .