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维生素 C 补充剂对血压的影响:随机对照试验的荟萃分析。

Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials.

机构信息

Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.

出版信息

Am J Clin Nutr. 2012 May;95(5):1079-88. doi: 10.3945/ajcn.111.027995. Epub 2012 Apr 4.

Abstract

BACKGROUND

In observational studies, increased vitamin C intake, vitamin C supplementation, and higher blood concentrations of vitamin C are associated with lower blood pressure (BP). However, evidence for blood pressure-lowering effects of vitamin C in clinical trials is inconsistent.

OBJECTIVE

The objective was to conduct a systematic review and meta-analysis of clinical trials that examined the effects of vitamin C supplementation on BP.

DESIGN

We searched Medline, EMBASE, and Central databases from 1966 to 2011. Prespecified inclusion criteria were as follows: 1) use of a randomized controlled trial design; 2) trial reported effects on systolic BP (SBP) or diastolic BP (DBP) or both; 3) trial used oral vitamin C and concurrent control groups; and 4) trial had a minimum duration of 2 wk. BP effects were pooled by random-effects models, with trials weighted by inverse variance.

RESULTS

Twenty-nine trials met eligibility criteria for the primary analysis. The median dose was 500 mg/d, the median duration was 8 wk, and trial sizes ranged from 10 to 120 participants. The pooled changes in SBP and DBP were -3.84 mm Hg (95% CI: -5.29, -2.38 mm Hg; P < 0.01) and -1.48 mm Hg (95% CI: -2.86, -0.10 mm Hg; P = 0.04), respectively. In trials in hypertensive participants, corresponding reductions in SBP and DBP were -4.85 mm Hg (P < 0.01) and -1.67 mm Hg (P = 0.17). After the inclusion of 9 trials with imputed BP effects, BP effects were attenuated but remained significant.

CONCLUSIONS

In short-term trials, vitamin C supplementation reduced SBP and DBP. Long-term trials on the effects of vitamin C supplementation on BP and clinical events are needed.

摘要

背景

在观察性研究中,增加维生素 C 的摄入、补充维生素 C 和提高血液中维生素 C 的浓度与降低血压(BP)有关。然而,临床试验中维生素 C 降低血压效果的证据并不一致。

目的

系统评价和荟萃分析维生素 C 补充剂对血压影响的临床试验。

设计

我们检索了 1966 年至 2011 年期间的 Medline、EMBASE 和中央数据库。预先设定的纳入标准如下:1)使用随机对照试验设计;2)试验报告了收缩压(SBP)或舒张压(DBP)或两者的影响;3)试验使用口服维生素 C 和对照试验组;4)试验持续时间至少 2 周。通过随机效应模型对血压影响进行汇总,试验权重为逆方差。

结果

29 项试验符合主要分析的纳入标准。中位数剂量为 500mg/d,中位数持续时间为 8 周,试验规模从 10 到 120 名参与者不等。SBP 和 DBP 的汇总变化分别为-3.84mmHg(95%CI:-5.29,-2.38mmHg;P<0.01)和-1.48mmHg(95%CI:-2.86,-0.10mmHg;P=0.04)。在高血压参与者的试验中,SBP 和 DBP 的相应降低分别为-4.85mmHg(P<0.01)和-1.67mmHg(P=0.17)。纳入 9 项具有推测血压影响的试验后,血压效应减弱,但仍有统计学意义。

结论

在短期试验中,维生素 C 补充剂降低了 SBP 和 DBP。需要进行长期试验来研究维生素 C 补充剂对血压和临床事件的影响。

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