维生素 B、维生素 C、维生素 D、维生素 E 和叶酸对原发性高血压成年人的影响：系统评价和网络荟萃分析。
Effect of vitamin B, vitamin C, vitamin D, vitamin E and folic acid in adults with essential hypertension: a systematic review and network meta-analysis.
机构信息
Gansu University of Chinese Medicine, Lanzhou, Gansu, China.
Gansu Provincial Cancer Hospital, Lanzhou, Gansu, China.
出版信息
BMJ Open. 2024 Jan 30;14(1):e074511. doi: 10.1136/bmjopen-2023-074511.
OBJECTIVES
The objective of the current study is to compare the treatment effects of different vitamins on essential hypertension to provide an initial basis for developing evidence-based practices.
DESIGN
Systematic review and network meta-analysis.
DATA SOURCES
Five electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov) were searched from their inception to 25 September 2023.
OUTCOMES
The primary outcomes were the difference between the intervention group and the control group in changes in office systolic blood pressure (SBP) and office diastolic blood pressure (DBP) from baseline. The secondary outcomes were the difference between the intervention group and the control group in changes in 24-hour mean ambulatory systolic blood pressure (24 hours SBP), 24-hour mean ambulatory diastolic blood pressure (24 hours DBP) and heart rate (HR) from baseline.
RESULTS
A total of 23 studies comparing five vitamins (vitamin B, vitamin C, vitamin D, vitamin E, folic acid) and involving 2218 participants were included. The included trials were all vitamin versus placebo, so the network was star-shaped. Among the five vitamins, only vitamin E was significantly more effective at reducing SBP (mean difference: -14.14 mm Hg, 95% credible intervals: -27.62 to -0.88) than placebo. In addition, no evidence was found that any of the five vitamins influenced DBP, 24 hours SBP, 24 hours DBP, or HR. The dose of vitamins, geographical region and percentage of males (only SBP) might be sources of heterogeneity. Sensitivity and subgroup analysis revealed that the effect of vitamin intervention on blood pressure varies according to different doses of vitamins.
CONCLUSIONS
According to the results, vitamin E might be an effective measure to reduce SBP, but more research is needed to validate this finding.
PROSPERO REGISTRATION NUMBER
CRD42022352332.
目的
本研究旨在比较不同维生素治疗原发性高血压的效果，为制定循证实践提供初步依据。
设计
系统评价和网络荟萃分析。
数据来源
从建库至 2023 年 9 月 25 日，检索了 5 个电子数据库（PubMed、Embase、Web of Science、Cochrane 中央对照试验注册库和 ClinicalTrials.gov）。
结局指标
主要结局指标为干预组与对照组在基线至随访期间的诊室收缩压（SBP）和诊室舒张压（DBP）变化的差值。次要结局指标为干预组与对照组在基线至随访期间的 24 小时平均动态 SBP（24 小时 SBP）、24 小时平均动态 DBP（24 小时 DBP）和心率（HR）变化的差值。
结果
共纳入 23 项比较 5 种维生素（维生素 B、维生素 C、维生素 D、维生素 E、叶酸）的研究，涉及 2218 名参与者。纳入的试验均为维生素与安慰剂对照，因此网络呈星形。在 5 种维生素中，只有维生素 E 降低 SBP 的效果明显优于安慰剂（平均差：-14.14mmHg，95%可信区间：-27.62 至-0.88）。此外，没有证据表明 5 种维生素中的任何一种影响 DBP、24 小时 SBP、24 小时 DBP 或 HR。维生素的剂量、地理区域和男性比例（仅 SBP）可能是异质性的来源。敏感性和亚组分析显示，维生素干预对血压的影响因维生素剂量的不同而有所不同。
结论
根据研究结果，维生素 E 可能是降低 SBP 的有效措施，但需要进一步研究来验证这一发现。
注册编号
CRD42022352332。
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