Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
Hellenic J Cardiol. 2024 Mar-Apr;76:99-109. doi: 10.1016/j.hjc.2023.07.010. Epub 2023 Aug 3.
Several systematic reviews (SRs) have investigated the association between ultra-processed foods (UPFs) and the risk of hypertension in various populations. However, the quality of the evidence remains unclear. This umbrella review was thus conducted to fill this gap.
We searched for SRs with and without meta-analyses comparing high UPF versus low UPF consumption on the risk of hypertension in the Cochrane Library, Embase, PubMed, and Web of Science from inception to August 2022. This study was registered in PROSPERO (No. CRD42022352934). The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis 2009 (PRISMA 2009) statement were used to evaluate the methodological and reporting quality of the included SRs. Stata 15/SE was used to reanalyse the data using the random-effects model, and the risk of bias of observational studies from included SRs was reassessed using the Newcastle-Ottawa Scale (NOS) tool. The certainty of the evidence body was assessed using the GRADE recommendation.
Seven SRs were included in the umbrella review. Among them, nine observational studies (5 cross-sectional and 4 cohort studies), whose available data were resynthesised using meta-analysis. The methodological and reporting quality of the included SRs were relatively poor. The meta-analysis results revealed suggestive evidence of an association between high UPF consumption and the incidence of hypertension (odds ratio: 1.23, 95% confidence interval: 1.11 to 1.37, p < 0.001, 95% prediction interval: 0.92 to 1.64, critically low certainty) compared to low UPF consumption.
High UPF consumption is associated with an increased risk of hypertension. However, well-conducted SRs, including high-quality prospective cohort studies, are needed to further verify these findings.
已有多项系统评价（SR）研究调查了超加工食品（UPF）与不同人群高血压风险之间的关联。然而，证据质量仍不清楚。因此，进行了这项伞式评价以填补这一空白。
我们检索了 Cochrane 图书馆、Embase、PubMed 和 Web of Science 从成立到 2022 年 8 月的比较高 UPF 与低 UPF 消费与高血压风险的 SR，包括有和没有 meta 分析的 SR。本研究已在 PROSPERO（注册号：CRD42022352934）注册。使用 A MeaSurement Tool to Assess systematic Reviews 2（AMSTAR-2）工具和 Preferred Reporting Item for Systematic Review and Meta-analysis 2009（PRISMA 2009）声明来评估纳入的 SR 的方法学和报告质量。使用 Stata 15/SE 软件采用随机效应模型重新分析数据，并使用 Newcastle-Ottawa Scale（NOS）工具重新评估纳入的 SR 中观察性研究的偏倚风险。使用 GRADE 建议评估证据体的确定性。
这项伞式评价纳入了 7 项 SR。其中，9 项观察性研究（5 项横断面研究和 4 项队列研究），使用 meta 分析综合了其可用数据。纳入的 SR 的方法学和报告质量相对较差。meta 分析结果提示，与低 UPF 消费相比，高 UPF 消费与高血压的发生之间存在关联（比值比：1.23，95%置信区间：1.11 至 1.37，p<0.001，95%预测区间：0.92 至 1.64，极低确定性）。
高 UPF 消费与高血压风险增加相关。然而，需要进行设计良好的 SR，包括高质量的前瞻性队列研究，以进一步验证这些发现。
