Li Juan, Zheng Hui, Du Huai-bin, Tian Xiao-ping, Jiang Yi-jing, Zhang Shao-lan, Kang Yu, Li Xiang, Chen Jie, Lu Chao, Lai Zhen-hong, Liang Fan-rong
Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
BMJ Open. 2014 Aug 14;4(8):e004920. doi: 10.1136/bmjopen-2014-004920.
The objective of this systematic review is to investigate the effectiveness, efficacy and safety of multiple concomitant lifestyle modification therapies for patients with hypertension or prehypertension.
Electronic searches will be performed in the Cochrane Library, OVID, EMBASE, etc, along with manual searches in the reference lists of relevant papers found during electronic search. We will identify eligible randomised controlled trials utilising multiple lifestyle modifications to lower blood pressure. The control could be drug therapy, single lifestyle change or no intervention. Changes in systolic blood pressure and diastolic blood pressure constitute primary end points, and secondary end points include the number of patients meeting the office target blood pressure, the number of patients reporting microvascular or macrovascular complications, etc. We will extract descriptive, methodological and efficacy data from identified randomised controlled trials (RCTs). We will calculate the relative risk for proportion of patients with a normal blood pressure in the experimental group. Dichotomous data will be analysed using risk difference and continuous data using weighted mean differences, both with 95% CI. We will use the χ(2) test and the I(2) statistic to assess heterogeneity. We will use the fixed effects model to compute the efficacy unless there is evidence of heterogeneity. If heterogeneity of effect size persists with respect to blood pressure change, further metaregression will be performed within groups. We will examine the potential for publication bias by using a funnel plot.
We will synthesise results from RCTs which provide more precise and accurate information on the effect of multiple lifestyle changes on blood pressure. The results of this review will increase the understanding of multiple lifestyle modifications for patients with hypertension or prehypertension.
Our protocol is registered on PROSPERO (CRD42013006476), http://www.crd.your.ac.uk/PROSPERO.
本系统评价的目的是研究多种联合生活方式改变疗法对高血压或高血压前期患者的有效性、疗效和安全性。
将在Cochrane图书馆、OVID、EMBASE等数据库进行电子检索，并对电子检索过程中发现的相关论文的参考文献列表进行手工检索。我们将识别使用多种生活方式改变来降低血压的合格随机对照试验。对照组可以是药物治疗、单一生活方式改变或不干预。收缩压和舒张压的变化构成主要终点，次要终点包括达到诊室目标血压的患者数量、报告微血管或大血管并发症的患者数量等。我们将从识别出的随机对照试验（RCT）中提取描述性、方法学和疗效数据。我们将计算实验组血压正常患者比例的相对风险。二分数据将使用风险差异进行分析，连续数据将使用加权平均差异进行分析，两者均带有95%置信区间。我们将使用χ²检验和I²统计量来评估异质性。除非有证据表明存在异质性，否则我们将使用固定效应模型来计算疗效。如果在血压变化方面效应大小的异质性仍然存在，将在组内进行进一步的元回归分析。我们将使用漏斗图来检查发表偏倚的可能性。
我们将综合随机对照试验的结果，这些结果能提供关于多种生活方式改变对血压影响的更精确和准确的信息。本评价的结果将增进对高血压或高血压前期患者多种生活方式改变的理解。
我们的方案已在PROSPERO（CRD42013006476）上注册，网址为http://www.crd.your.ac.uk/PROSPERO。
