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 .
Sodium restriction and blood pressure in hypertensive type II diabetics: randomised blind controlled and crossover studies of moderate sodium restriction and sodium supplementation.
OBJECTIVE --To determine the effect of moderate dietary sodium restriction on the hypertension of non-insulin-dependent ( type II ) diabetes . DESIGN --R and omised parallel controlled study of moderate sodium restriction for three months compared with usual diabetic diet , followed by r and omised double blind crossover trial of sustained release preparation of sodium for one month versus placebo for one month in patients continuing with sodium restriction . SETTING -- Patients attending diabetic outpatient clinic of city hospital . PATIENTS --Thirty four patients with established type II diabetes complicated by mild hypertension ( systolic blood pressure greater than 160 mm Hg or diastolic pressure greater than 95 mm Hg on three consecutive occasions ) . Patients already taking antihypertensive agents ( but not diuretics ) not barred from study provided that criteria for mild hypertension still met . Conditions precluding patients from study were diabetic or hypertensive nephropathy , cardiac failure , and pregnancy . INTERVENTIONS --After run in phase with recordings at seven weeks , three weeks , and time zero patients were allocated at r and om to receive moderate dietary sodium restriction for three months ( n = 17 ) or to continue with usual diabetic diet . Subsequently nine patients in sodium restriction group continued with regimen for a further two months , during which they completed a r and omised double blind crossover trial of sustained release preparation of sodium ( Slow Sodium 80 mmol daily ) for one month versus matching placebo for one month . END POINT -- Reduction in blood pressure in type II diabetics with mild hypertension . MEASUREMENTS AND MAIN RESULTS --Supine and erect blood pressure , body weight , and 24 hour urinary sodium and potassium excretion measured monthly during parallel group and double blind crossover studies . After parallel group study sodium restriction group showed significant reduction in systolic blood pressure ( supine 19.2 mm Hg , erect 21.4 mm Hg ; p less than 0.001 ) and mean daily urinary sodium excretion ( mean reduction 60 mmol/24 h ) . There were no appreciable changes in weight , diabetic control , or diastolic pressure . No significant changes occurred in controls . In double blind crossover study mean supine systolic blood pressure rose significantly ( p less than 0.005 ) during sodium supplementation ( to 171 mm Hg ) compared with value after three months of sodium restriction alone ( 159.9 mm Hg ) and after one month of placebo ( 161.8 mm Hg ) . CONCLUSIONS --Moderate dietary restriction of sodium has a definite hypotensive effect , which may be useful in mild hypertension of type II diabetes
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 .