Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Population Health Research Institute, Hamilton, Ontario, Canada.
BMJ Open. 2022 Dec 9;12(12):e059666. doi: 10.1136/bmjopen-2021-059666.
The cardiovascular disease (CVD) burden among South Asians is high. Lifestyle interventions have been effective in the primary prevention of CVD, but this has not been replicated, through a synthesis of randomised trials, in South Asians.
Four electronic databases (MEDLINE, Embase, CENTRAL and CINAHL), two clinical trial registries and references of included articles were searched through June 2022 (featuring ≥90% South Asian participants). Random-effects pairwise meta-analyses were performed, and heterogeneity was quantified with the I statistic. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was used to report on the quality of evidence (International Prospective Register of Systematic Reviews registration (PROSPERO).
Thirty-five studies were included. Twelve tested diet and physical activity interventions; 18 tested diet alone; and 5 tested physical activity alone. All reported effects of the intervention(s) on at least one established risk factor for CVD, including blood pressure (systolic blood pressure (SBP), diastolic blood pressure (DBP) and blood lipids (high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc) or triglycerides). No trials reported clinical CVD. There is moderate-quality evidence that diet and physical activity interventions improve SBP (mean difference (MD) -2.72 mm Hg, 95% CI -4.11 to -1.33) and DBP (MD -1.53 mm Hg, 95% CI -2.57 to -0.48); high-quality to moderate-quality evidence that diet-only interventions improve DBP (MD -2.05 mm Hg, 95% CI -2.93 to -1.16) and blood lipids (triglycerides (MD -0.10 mmol/L, 95% CI -0.14 to -0.06) and LDLc (MD -0.19 mmol/L, 95% CI -0.32 to -0.06)); and moderate-quality evidence that physical activity-only interventions improve SBP (MD -9.7 mm Hg, 95% CI -11.05 to -8.35), DBP (MD -7.29 mm Hg, 95% CI -8.42 to -6.16) and HDLc (MD 0.08 mmol/L, 95% CI 0.04 to 0.11) compared with usual care.
Lifestyle interventions improve blood pressure and blood lipid profiles in adult South Asians at risk of CVD. Tailored interventions should be used to modify cardiovascular risk factors in this at-risk group.
CRD42018090419.
南亚人群的心血管疾病（CVD）负担很高。生活方式干预已被证明可有效预防 CVD，但通过对随机试验的综合分析，这种方法并未在南亚人群中得到复制。
检索了四个电子数据库（MEDLINE、Embase、CENTRAL 和 CINAHL）、两个临床试验注册处和纳入文章的参考文献，检索时间截至 2022 年 6 月（参与者中至少有 90%为南亚人）。进行了随机效应成对荟萃分析，并使用 I 统计量来量化异质性。使用推荐、评估、制定和评估（GRADE）框架报告证据质量（国际前瞻性系统评价注册处（PROSPERO）注册）。
纳入了 35 项研究。12 项研究测试了饮食和身体活动干预措施；18 项研究仅测试了饮食；5 项研究仅测试了身体活动。所有研究都报告了干预措施对 CVD 至少一种既定风险因素的影响，包括血压（收缩压（SBP）、舒张压（DBP）和血液脂质（高密度脂蛋白胆固醇（HDLc）、低密度脂蛋白胆固醇（LDLc）或甘油三酯）。没有试验报告临床 CVD。有中等质量证据表明，饮食和身体活动干预措施可改善 SBP（平均差值（MD）-2.72mmHg，95%CI-4.11 至-1.33）和 DBP（MD-1.53mmHg，95%CI-2.57 至-0.48）；高质量到中等质量证据表明，仅饮食干预可改善 DBP（MD-2.05mmHg，95%CI-2.93 至-1.16）和血液脂质（甘油三酯（MD-0.10mmol/L，95%CI-0.14 至-0.06）和 LDLc（MD-0.19mmol/L，95%CI-0.32 至-0.06））；以及中等质量证据表明，仅身体活动干预可改善 SBP（MD-9.7mmHg，95%CI-11.05 至-8.35）、DBP（MD-7.29mmHg，95%CI-8.42 至-6.16）和 HDLc（MD 0.08mmol/L，95%CI 0.04 至 0.11）与常规护理相比。
生活方式干预可改善 CVD 高危的南亚成年人的血压和血液脂质谱。应使用针对性的干预措施来改变该高危人群的心血管风险因素。
PROSPERO 注册号：CRD42018090419。
