Zhang Haili, Liu Shuang, Li Lan, Liu Shisong, Liu Shuqi, Mi Jia, Tian Geng
College of Pharmacy, Binzhou Medical University School of Enology, Binzhou Medical University Medicine and Pharmacy Research Center, Binzhou Medical University, Yantai, Shandong, China.
Medicine (Baltimore). 2016 Aug;95(33):e4247. doi: 10.1097/MD.0000000000004247.
Several clinical trials have shown that grape seed extract can reduce blood pressure, but the results are often irreproducible. We therefore sought to systematically evaluate the impact of grape seed extract treatment on the changes of systolic/diastolic blood pressure (SBP/DBP) by meta-analyzing available randomized controlled trials.
Trial selection and data extraction were completed independently by 2 investigators. Effect-size estimates were expressed as weighted mean difference (WMD) and 95% confidence interval (CI).
Twelve articles involving 16 clinical trials and 810 study subjects were analyzed. Overall analyses found significant reductions for SBP (WMD = -6.077; 95% CI: -10.736 to -1.419; P = 0.011) and DBP (WMD = -2.803; 95% CI: -4.417 to -1.189; P = 0.001) after grape seed extract treatment. In subgroup analyses, there were significant reductions in younger subjects (mean age < 50 years) for SBP (WMD = -6.049; 95% CI: -10.223 to -1.875; P = 0.005) and DBP (WMD = -3.116; 95% CI: -4.773 to -1.459; P < 0.001), in obese subjects (mean body mass index ≥ 25 kg/m) for SBP (WMD = -4.469; 95% CI: -6.628 to -2.310; P < 0.001), and in patients with metabolic syndrome for SBP (WMD = -8.487; 95% CI: -11.869 to -5.106; P < 0.001). Further meta-regression analyses showed that age, body mass index, and baseline blood pressure were negatively associated with the significant reductions of SBP and DBP after treatment. There was no indication of publication bias.
Our findings demonstrate that grape seed extract exerted a beneficial impact on blood pressure, and this impact was more obvious in younger or obese subjects, as well as in patients with metabolic disorders. In view of the small sample size involved, we agree that confirmation of our findings in a large-scale, long-term, multiple-dose randomized controlled trial, especially among hypertensive patients is warranted.
多项临床试验表明葡萄籽提取物可降低血压,但结果往往难以重复。因此,我们试图通过对现有随机对照试验进行荟萃分析,系统评估葡萄籽提取物治疗对收缩压/舒张压(SBP/DBP)变化的影响。
由2名研究人员独立完成试验筛选和数据提取。效应量估计值以加权均数差(WMD)和95%置信区间(CI)表示。
分析了12篇文章,涉及16项临床试验和810名研究对象。总体分析发现,葡萄籽提取物治疗后SBP(WMD = -6.077;95%CI:-10.736至-1.419;P = 0.011)和DBP(WMD = -2.803;95%CI:-4.417至-1.189;P = 0.001)显著降低。亚组分析显示,年龄较轻(平均年龄<50岁)的受试者SBP(WMD = -6.049;95%CI:-10.223至-1.875;P = 0.005)和DBP(WMD = -3.116;95%CI:-4.773至-1.459;P<0.001)显著降低,肥胖受试者(平均体重指数≥25kg/m²)的SBP(WMD = -4.469;95%CI:-6.628至-2.310;P<0.001)以及代谢综合征患者的SBP(WMD = -8.487;95%CI:-11.869至-5.106;P<0.001)显著降低。进一步的荟萃回归分析表明,年龄、体重指数和基线血压与治疗后SBP和DBP的显著降低呈负相关。没有证据表明存在发表偏倚。
我们的研究结果表明葡萄籽提取物对血压有有益影响,这种影响在年轻或肥胖受试者以及代谢紊乱患者中更为明显。鉴于所涉及的样本量较小,我们同意有必要在大规模、长期、多剂量随机对照试验中,尤其是在高血压患者中证实我们的研究结果。