Onakpoya I J, Spencer E A, Thompson M J, Heneghan C J
University of Oxford, Nuffield Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, UK.
1] University of Oxford, Nuffield Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, UK [2] Department of Family Medicine, University of Washington, Seattle, WA, USA.
J Hum Hypertens. 2015 Feb;29(2):77-81. doi: 10.1038/jhh.2014.46. Epub 2014 Jun 19.
Several dietary supplements are currently marketed for management of hypertension, but the evidence for effectiveness is conflicting. Our objective was to critically appraise and evaluate the evidence for the effectiveness of chlorogenic acids (CGAs) on blood pressure, using data from published randomized clinical trials (RCTs). Electronic searches were conducted in Medline, Embase, Amed, Cinahl and The Cochrane Library. We also hand-searched the bibliographies of all retrieved articles. Two reviewers independently determined the eligibility of studies and extracted the data. The reporting quality of all included studies was assessed by the use of a quality assessment checklist adapted from the Consolidated Standard of Reporting Trials Statement. Disagreements were resolved through discussion. Seven eligible studies were identified, and five including 364 participants were included. There were variations in the reporting quality of the included RCTs. Meta-analysis revealed a statistically significant reduction in systolic blood pressure in favour of CGA (mean difference (MD): -4.31 mm Hg; 95% confidence interval (CI): -5.60 to -3.01; I(2)=65%; P<0.00001). Meta-analysis also showed a significant reduction in diastolic blood pressure favouring CGA (MD: -3.68 mm Hg; 95% CI: -3.91 to -3.45; I(2)=97%; P<0.00001). All studies reported no adverse events. In conclusion, the evidence from published RCTs suggests that CGA intake causes statistically significant reductions in systolic and diastolic blood pressures. The size of the effect is moderate. Few clinical trials have been conducted; they vary in design and methodology and are confined to Asian populations and funded by CGA manufacturers. Large independent trials evaluating the effects of CGA on blood pressure are warranted.
目前有几种膳食补充剂在市场上销售用于管理高血压，但关于其有效性的证据相互矛盾。我们的目的是利用已发表的随机临床试验（RCT）数据，严格评估绿原酸（CGA）对血压有效性的证据。在Medline、Embase、Amed、Cinahl和Cochrane图书馆进行了电子检索。我们还手工检索了所有检索到文章的参考文献。两名评审员独立确定研究的 eligibility 并提取数据。所有纳入研究的报告质量通过使用根据《报告试验的统一标准声明》改编的质量评估清单进行评估。分歧通过讨论解决。确定了7项 eligible 研究，纳入了5项包括364名参与者的研究。纳入的RCT报告质量存在差异。荟萃分析显示，收缩压有统计学意义的降低，有利于CGA（平均差异（MD）：-4.31 mmHg；95%置信区间（CI）：-5.60至-3.01；I²=65%；P<0.00001）。荟萃分析还显示舒张压有显著降低，有利于CGA（MD：-3.68 mmHg；95%CI：-3.91至-3.45；I²=97%；P<0.00001）。所有研究均未报告不良事件。总之，已发表的RCT证据表明，摄入CGA会使收缩压和舒张压有统计学意义的降低。效果大小适中。进行的临床试验很少；它们在设计和方法上各不相同，且仅限于亚洲人群并由CGA制造商资助。有必要进行大型独立试验来评估CGA对血压的影响。
