School of Psychology, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33, Ireland.
School of Mathematics, Statistics & Applied Mathematics, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33, Ireland.
Syst Rev. 2018 Aug 21;7(1):128. doi: 10.1186/s13643-018-0791-9.
The prevalence of hypertension is a major public health challenge. Despite it being highly preventable, hypertension is responsible for a significant proportion of global morbidity and mortality. Common methods for controlling hypertension include prescribing anti-hypertensive medication, a pharmacological approach, and increasing physical activity, a behavioural approach. In general, little is known about the comparative effectiveness of pharmacological and behavioural approaches for reducing blood pressure in hypertension. A previous network meta-analysis suggested that physical activity interventions may be just as effective as many anti-hypertensive medications in preventing mortality; however, this analysis did not provide the comparative effectiveness of these disparate modes of intervention on blood pressure reduction. The primary objective of this study is to use network meta-analysis to compare the relative effectiveness, for blood pressure reduction, of different approaches to increasing physical activity and different first-line anti-hypertensive therapies in people with hypertension.
A systematic review will be conducted to identify studies involving randomised controlled trials which compare different types of physical activity interventions and first-line anti-hypertensive therapy interventions to each other or to other comparators (e.g. placebo, usual care) where blood pressure reduction is the primary outcome. We will search the Cochrane Library, MEDLINE and PsycInfo. For studies which meet our inclusion criteria, two reviewers will extract data independently and assess the quality of the literature using the Cochrane Risk of Bias Tool. Network meta-analyses will be conducted to generate estimates of comparative effectiveness of each intervention class and rankings of their effectiveness, in terms of reduction of both systolic and diastolic blood pressure.
This study will provide evidence regarding the comparability of two common first-line treatment options for people with hypertension. It will also describe the extent to which there is direct evidence regarding the comparative effectiveness of increasing physical activity and initiating anti-hypertensive therapy.
PROSPERO CRD42017070579.
高血压的患病率是一个主要的公共卫生挑战。尽管高血压可以得到高度预防，但它仍是导致全球发病率和死亡率的一个重要因素。控制高血压的常见方法包括开降压药，这是一种药理学方法，以及增加身体活动，这是一种行为学方法。一般来说，人们对降低高血压的药理学和行为学方法的相对有效性知之甚少。先前的网络荟萃分析表明，身体活动干预可能与许多降压药物一样有效，可预防死亡；然而，这项分析并没有提供这些不同干预模式在降低血压方面的相对有效性。本研究的主要目的是使用网络荟萃分析比较增加身体活动和不同一线抗高血压治疗方法在降低高血压患者血压方面的相对有效性。
我们将进行系统评价，以确定涉及随机对照试验的研究，这些研究将比较不同类型的身体活动干预和一线抗高血压治疗干预彼此之间或与其他对照（例如安慰剂、常规护理）之间的差异，主要结局为血压降低。我们将搜索 Cochrane 图书馆、MEDLINE 和 PsycInfo。对于符合我们纳入标准的研究，两位评审员将独立提取数据，并使用 Cochrane 偏倚风险工具评估文献质量。我们将进行网络荟萃分析，以生成每种干预类别的相对有效性估计值，并根据收缩压和舒张压的降低情况对其有效性进行排名。
这项研究将提供有关两种常见一线治疗选择对高血压患者的可比性的证据。它还将描述在增加身体活动和开始抗高血压治疗的相对有效性方面，直接证据的程度。
PROSPERO CRD42017070579。
