Dickinson Heather O, Mason James M, Nicolson Donald J, Campbell Fiona, Beyer Fiona R, Cook Julia V, Williams Bryan, Ford Gary A
University of Newcastle upon Tyne, Centre for Health Services Research, Newcastle upon Tyne, UK.
J Hypertens. 2006 Feb;24(2):215-33. doi: 10.1097/01.hjh.0000199800.72563.26.
To quantify effectiveness of lifestyle interventions for hypertension.
Electronic bibliographic databases from 1998 onwards, existing guidelines, systematic reviews.
We included randomized, controlled trials with at least 8 weeks' follow-up, comparing lifestyle with control interventions, enrolling adults with blood pressure at least 140/85 mmHg. Primary outcome measures were systolic and diastolic blood pressure. Two independent reviewers selected trials and abstracted data; differences were resolved by discussion.
We categorized trials by type of intervention and used random effects meta-analysis to combine mean differences between endpoint blood pressure in treatment and control groups in 105 trials randomizing 6805 participants. Robust statistically significant effects were found for improved diet, aerobic exercise, alcohol and sodium restriction, and fish oil supplements: mean reductions in systolic blood pressure of 5.0 mmHg [95% confidence interval (CI): 3.1-7.0], 4.6 mmHg (95% CI: 2.0-7.1), 3.8 mmHg (95% CI: 1.4-6.1), 3.6 mmHg (95% CI: 2.5-4.6) and 2.3 mmHg (95% CI: 0.2-4.3), respectively, with corresponding reductions in diastolic blood pressure. Relaxation significantly reduced blood pressure only when compared with non-intervention controls. We found no robust evidence of any important effect on blood pressure of potassium, magnesium or calcium supplements.
Patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake. Available evidence does not support relaxation therapies, calcium, magnesium or potassium supplements to reduce blood pressure.
量化生活方式干预对高血压的有效性。
1998年起的电子文献数据库、现有指南、系统评价。
我们纳入了至少随访8周的随机对照试验，比较生活方式干预与对照干预，纳入收缩压至少为140/85 mmHg的成年人。主要结局指标为收缩压和舒张压。两名独立的评审员选择试验并提取数据；差异通过讨论解决。
我们根据干预类型对试验进行分类，并使用随机效应荟萃分析来合并105项试验中治疗组和对照组终点血压的平均差异，这些试验共纳入6805名参与者。在改善饮食、有氧运动、限制酒精和钠摄入以及补充鱼油方面发现了具有统计学意义的显著效果：收缩压平均降低5.0 mmHg [95%置信区间（CI）：3.1 - 7.0]、4.6 mmHg（95% CI：2.0 - 7.1）、3.8 mmHg（95% CI：1.4 - 6.）、3.6 mmHg（95% CI：2.5 - 4.6）和2.3 mmHg（95% CI：0.2 - 4.3），舒张压也相应降低。仅与非干预对照组相比时，放松疗法能显著降低血压。我们未发现钾、镁或钙补充剂对血压有任何重要影响的确凿证据。
血压升高的患者应遵循减重饮食、定期锻炼，并限制酒精和盐的摄入。现有证据不支持采用放松疗法、补充钙、镁或钾来降低血压。
