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钙和维生素 D 联合补充对血压的影响:系统评价和荟萃分析。

Effect of Calcium and Vitamin D Co-supplementation on Blood Pressure: A Systematic Review and Meta-Analysis.

机构信息

Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.

出版信息

Clin Ther. 2020 Mar;42(3):e45-e63. doi: 10.1016/j.clinthera.2020.01.005. Epub 2020 Feb 14.

Abstract

PURPOSE

Vitamin D and calcium insufficiency has been related to elevated blood pressure (BP) and cardiovascular complications. This systematic review and meta-analysis investigates the effect of calcium and vitamin D co-supplementation on BP.

METHODS

A systematic search was conducted of electronic databases, including Web of Sciences, MEDLINE, Scopus, EMBASE, and the Cochrane Library, along with searches of gray literature and reference lists from included trials. There were no language restrictions, and the databases were searched from inception to October 2019. Randomized controlled trials, using calcium and vitamin D co-supplementation and reporting mean systolic BP and/or diastolic BP (DBP) with SDs, were included in the systematic review. Articles were evaluated independently by 2 researchers based on inclusion and exclusion criteria. A random effects model was conducted to synthesize the data.

FINDINGS

Eight trials were included in the meta-analysis. Meta-analysis of these 8 trials indicated a nonsignificant reduction in systolic BP in the calcium and vitamin D co-supplementation group compared with control (standardized mean difference, -0.23; 95% CI, -0.52 to 0.06). Conversely, there was a statistically significant decrease in DBP (standardized mean difference, -0.29; 95% CI, -0.55 to -0.02). Subgroup analysis suggested that young adults achieve a greater reduction in DBP than other age groups.

IMPLICATIONS

Calcium and vitamin D co-supplementation can modulate DBP and should be investigated more specifically in large, well-designed trials of hypertensive populations. (Clin Ther. 2020;42:XXX-XXX) © 2020 Elsevier HS Journals, Inc.

摘要

目的

维生素 D 和钙不足与血压升高(BP)和心血管并发症有关。本系统评价和荟萃分析调查了钙和维生素 D 联合补充对 BP 的影响。

方法

系统检索了电子数据库,包括 Web of Sciences、MEDLINE、Scopus、EMBASE 和 Cochrane 图书馆,以及纳入试验的灰色文献和参考文献列表的搜索。没有语言限制,数据库从创建到 2019 年 10 月进行搜索。纳入的系统评价包括使用钙和维生素 D 联合补充并报告均数收缩压和/或舒张压(DBP)及标准差的随机对照试验。文章由 2 位研究人员根据纳入和排除标准独立评估。采用随机效应模型对数据进行综合分析。

结果

有 8 项试验纳入荟萃分析。对这 8 项试验的荟萃分析表明,与对照组相比,钙和维生素 D 联合补充组的收缩压无显著降低(标准化均数差,-0.23;95%CI,-0.52 至 0.06)。相反,DBP 有统计学显著降低(标准化均数差,-0.29;95%CI,-0.55 至-0.02)。亚组分析表明,年轻成年人 DBP 的降低幅度大于其他年龄组。

结论

钙和维生素 D 联合补充可以调节 DBP,应在高血压人群的大型、精心设计的试验中更具体地进行研究。(临床治疗。2020;42:XXX-XXX)©2020 Elsevier HS 期刊,公司

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