First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Department of Cardiology, Helena Venizelou Hospital, Athens, Greece.
Clin Nutr. 2021 May;40(5):3191-3200. doi: 10.1016/j.clnu.2021.01.030. Epub 2021 Jan 29.
BACKGROUND & AIMS: It is unclear whether the Mediterranean diet (MedDiet) has a favorable effect on blood pressure (BP) levels because among randomized controlled trials (RCTs) investigating the MedDiet-mediated BP reduction significant methodological and clinical differences are observed. The purpose of this study was to comprehensively assess the MedDiet BP-effect compared to the usual diet or another dietary intervention (e.g. low-fat diet) in adults with and without hypertension, accounting for methodological and clinical confounders.
We systematically searched Medline and the Cochrane Collaboration Library databases and identified 35 RCTs (13,943 participants). Random-effects model was used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted.
Compared to the usual diet and all other active intervention diets the MedDiet reduced SBP and DBP (difference in means: -1.5 mm Hg; 95% CI: -2.8, -0.1; P = 0.035, and -0.9 mm Hg; 95% CI: -1.5, -0.3; P = 0.002, respectively). Compared only to the usual diet the MedDiet reduced SBP and DBP, while compared to all other active intervention diets or only to the low-fat diet the MedDiet did not reduce SBP and DBP. The MedDiet reduced DBP levels to a higher extent in trials with mean baseline SBP ≥130 mm Hg, while both SBP and DBP were reduced more in trials with a mean follow-up period ≥16 weeks. The quality of evidence was rated as moderate for both outcomes according to the grading of recommendations, assessment, development and evaluation (GRADE) approach.
The adoption of the MedDiet was accompanied by a relatively small, but yet significant BP reduction, while higher baseline SBP levels and longer follow-up duration enhanced the BP-lowering effect of the intervention. This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42020167308.
CRD42020167308.
地中海饮食（MedDiet）是否对血压（BP）水平有有利影响尚不清楚，因为在研究 MedDiet 介导的 BP 降低的随机对照试验（RCT）中，观察到显著的方法学和临床差异。本研究的目的是全面评估与常规饮食或其他饮食干预（例如低脂饮食）相比，地中海饮食对高血压和非高血压成年人的 BP 效应，同时考虑方法学和临床混杂因素。
我们系统地检索了 Medline 和 Cochrane 合作图书馆数据库，确定了 35 项 RCT（13943 名参与者）。使用随机效应模型计算随访期间平均收缩压（SBP）和舒张压（DBP）的差异。还进行了亚组和荟萃回归分析。
与常规饮食和所有其他积极干预饮食相比，地中海饮食降低了 SBP 和 DBP（平均差异：-1.5mmHg；95%置信区间：-2.8，-0.1；P=0.035 和-0.9mmHg；95%置信区间：-1.5，-0.3；P=0.002）。与常规饮食相比，地中海饮食仅降低了 SBP 和 DBP，而与所有其他积极干预饮食或仅与低脂饮食相比，地中海饮食并未降低 SBP 和 DBP。在基线 SBP≥130mmHg 的试验中，地中海饮食降低 DBP 水平的幅度更大，而在平均随访期≥16 周的试验中，SBP 和 DBP 的降低幅度更大。根据推荐评估、发展和评价（GRADE）方法，这两种结局的证据质量均被评为中度。
采用地中海饮食会伴随相对较小但有统计学意义的 BP 降低，而较高的基线 SBP 水平和较长的随访时间会增强干预的降压效果。本荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为 CRD42020167308。
CRD42020167308。
