Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
Am J Epidemiol. 2012 Oct 1;176 Suppl 7:S27-43. doi: 10.1093/aje/kws245.
The authors conducted a meta-analysis of randomized controlled trials to evaluate the association of dietary protein intake with blood pressure. To identify articles published before April 2011, the authors searched electronic databases, conducted a manual bibliography review, and consulted experts in the field. Forty trials (including 3,277 participants in total) met the eligibility criteria and were included. Using a standardized form, 2 investigators independently abstracted data on study design, participant characteristics, and treatment outcomes. Net change estimates were pooled across trials using random-effects models. Compared with carbohydrate, dietary protein intake was associated with significant changes in mean systolic and diastolic blood pressure of -1.76 mm Hg (95% confidence interval (CI): -2.33, -1.20) and -1.15 mm Hg (95% CI: -1.59, -0.71), respectively (both P 's < 0.001). Both vegetable protein and animal protein were associated with significant blood pressure changes of -2.27 mm Hg (95% CI: -3.36, -1.18) and -2.54 mm Hg (95% CI: -3.55, -1.53), respectively, for systolic blood pressure (both P 's < 0.001) and -1.26 mm Hg (95% CI: -2.26, -0.26) and -0.95 mm Hg (95% CI: -1.72, -0.19), respectively, for diastolic blood pressure (both P 's = 0.014). Blood pressure reduction was not significantly different when vegetable protein was compared directly with animal protein. These findings indicate that partially replacing dietary carbohydrate with protein may be important for the prevention and treatment of hypertension.
作者进行了一项荟萃分析随机对照试验，以评估饮食蛋白质摄入量与血压之间的关联。为了确定发表于 2011 年 4 月之前的文章，作者检索了电子数据库，进行了手工文献回顾，并咨询了该领域的专家。有 40 项试验（总共包括 3277 名参与者）符合入选标准并被纳入。使用标准化表格，两名调查员独立提取研究设计、参与者特征和治疗结局的数据。使用随机效应模型汇总试验间的净变化估计值。与碳水化合物相比，饮食蛋白质摄入量与收缩压和舒张压的平均变化分别为-1.76mmHg（95%置信区间：-2.33，-1.20）和-1.15mmHg（95%置信区间：-1.59，-0.71）相关（均 P<0.001）。植物蛋白和动物蛋白与收缩压的显著变化相关，分别为-2.27mmHg（95%置信区间：-3.36，-1.18）和-2.54mmHg（95%置信区间：-3.55，-1.53）（均 P<0.001），以及舒张压的显著变化，分别为-1.26mmHg（95%置信区间：-2.26，-0.26）和-0.95mmHg（95%置信区间：-1.72，-0.19）（均 P=0.014）。当直接比较植物蛋白和动物蛋白时，血压降低没有显著差异。这些发现表明，用蛋白质部分替代饮食中的碳水化合物可能对高血压的预防和治疗很重要。
