scholarly journals Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies

Antioxidants ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. 152 ◽  
Author(s):  
Justyna Godos ◽  
Marilena Vitale ◽  
Agnieszka Micek ◽  
Sumantra Ray ◽  
Daniela Martini ◽  
...  

Background: Dietary polyphenols, including flavonoids, have been the focus of major recent attentions due to their wide content in a variety of foods commonly consumed and the findings from numerous studies showing evidence of an association with positive outcomes on human health. Methods: A systematic search using electronic databases PubMed and EMBASE was performed to retrieve English language studies published from the earliest indexing year of each database to April 2019, reporting on the association between dietary flavonoids intake and hypertension. Results: The search strategy resulted in the final selection of 20 studies including 15 cross-sectional investigations and 7 prospective cohorts (1 study reported on 3 prospective cohorts). 5 prospective cohorts, comprising 200,256 individuals and 45,732 cases of hypertension were included in the quantitative analysis. Analysis by extreme quantiles of intake of flavonoid showed a non-significant association with decreased risk of hypertension (RR (risk ratio): 0.96, 95% CI (confidence interval): 0.89, 1.03). Taking into consideration individual flavonoid subclasses, dietary anthocyanins intake was associated with 8% reduction in risk of hypertension, when comparing highest vs. lowest exposure (RR: 0.92, 95% CI: 0.88, 0.97). Conclusions: Further studies are needed to strengthen the retrieved association between anthocyanins consumption and decreased risk of hypertension and clarify whether total flavonoids or rather individual subclasses may exert beneficial effects on blood pressure.

Lupus ◽  
2021 ◽  
pp. 096120332110071
Author(s):  
Jiaoniu Duan ◽  
Dan Ma ◽  
Xiaoting Wen ◽  
Qianyu Guo ◽  
Jinfang Gao ◽  
...  

Objectives This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases’ inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ− group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software. Results Nine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ− group (OR 0.35, 95% CI 0.21–0.59), (OR 0.41, 95% CI 0.19–0.89) and (OR 0.55, 95% CI 0.36–0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19–3.96), gestational diabetes (OR 2.3, 95% CI 0.44–12.12), thrombotic events (OR 0.26, 95% CI 0.05–1.51), spontaneous abortion (OR 1.77, 95% CI 0.96–3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24–1.39), oligohydramnios (OR 0.90, 95% CI 0.38–2.14), live birth (OR 1.22, 95% CI 0.60–2.47), stillbirth (OR 1.00, 95% CI 0.50–2.00), congenital malformation (OR 0.53, 95% CI 0.14–2.04), low birth weight (OR 0.77, 95% CI 0.43–1.39), intrauterine distress (OR 1.07, 95% CI 0.41–2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06–5.43), or five-minute APGAR score <7 (OR 0.72, 95% CI 0.20–2.58) between the two groups. Conclusions HCQ treatment during pregnancy could reduce the risk of preeclampsia, pregnancy hypertension and prematurity in SLE patients. The certainty of evidence is high but majority of the studies included are retrospective studies and not randomized controlled trials. Therefore, the multidisciplinary management of pregnant patients with SLE should promote HCQ use, irrespective of disease activity or severity.


Author(s):  
Ewan Thomas ◽  
Marianna Bellafiore ◽  
Ambra Gentile ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  

AbstractThe aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a “fair-to-good” quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040481
Author(s):  
Sinead T J McDonagh ◽  
James P Sheppard ◽  
Fiona C Warren ◽  
Kate Boddy ◽  
Leon Farmer ◽  
...  

IntroductionBlood pressure (BP) is normally measured on the upper arm, and guidelines for the diagnosis and treatment of high BP are based on such measurements. Leg BP measurement can be an alternative when brachial BP measurement is impractical, due to injury or disability. Limited data exist to guide interpretation of leg BP values for hypertension management; study-level systematic review findings suggest that systolic BP (SBP) is 17 mm Hg higher in the leg than the arm. However, uncertainty remains about the applicability of this figure in clinical practice due to substantial heterogeneity.AimsTo examine the relationship between arm and leg SBP, develop and validate a multivariable model predicting arm SBP from leg SBP and investigate the prognostic association between leg SBP and cardiovascular disease and mortality.Methods and analysisIndividual participant data (IPD) meta-analyses using arm and leg SBP measurements for 33 710 individuals from 14 studies within the Inter-arm blood pressure difference IPD (INTERPRESS-IPD) Collaboration. We will explore cross-sectional relationships between arm and leg SBP using hierarchical linear regression with participants nested by study, in multivariable models. Prognostic models will be derived for all-cause and cardiovascular mortality and cardiovascular events.Ethics and disseminationData originate from studies with prior ethical approval and consent, and data sharing agreements are in place—no further approvals are required to undertake the secondary analyses proposed in this protocol. Findings will be published in peer-reviewed journal articles and presented at conferences. A comprehensive dissemination strategy is in place, integrated with patient and public involvement.PROSPERO registration numberCRD42015031227.


2020 ◽  
Vol 9 ◽  
pp. 1743
Author(s):  
Solmaz Rahmani Barouji ◽  
Amir Saber ◽  
Mohammadali Torbati ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ahmad Yari Khosroushahi

raditional medicine (TM) that developed over the years within various societies consists of medical experimental knowledge and practices, which apply natural methods and compounds for general wellness and healing. Moomiaii as a pale-brown to blackish-brown natural exudate is one of the natural compounds in traditional medicine that has been used over 3000 years in many countries of the world especially in India, China, Russia, Iran, Mongolia, Kazakhstan and Kirgizstan. We reviewed all English-language studies about Moomiaii that we accessed them. In traditional medicine, many beneficial activities have been attributed to Moomiaii and to its main constituents, Humic acid and Fulvic acid, which are widely used to prevent and treatment of different diseases. Some modern scientific investigations showed that Moomiaii as a safe dietary supplement can be beneficial in various health complications. Even though the beneficial effects of Moomiaii have been confirmed in traditional and modern medicine, it seems that additional in-vitro/in-vivo studies and comprehensive clinical trials are necessary to explain the whole mechanisms of action and to determine the effective doses in various diseases. We discuss and clarify the claimed health beneficial effects of Moomiaii in some wide-spread diseases regarding its anti-ulcerogenic, immunomodulatory, antidiabetic, antioxidative and anticancer properties. [GMJ.2020;9:e1743]


Author(s):  
Abdullah Bandar Alansare ◽  
Lauren C. Bates ◽  
Lee Stoner ◽  
Christopher E. Kline ◽  
Elizabeth Nagle ◽  
...  

Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. Results: Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected. Conclusions: The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.


2019 ◽  
Vol 22 (15) ◽  
pp. 2823-2834 ◽  
Author(s):  
Elnaz Daneshzad ◽  
Fahimeh Haghighatdoost ◽  
Leila Azadbakht

AbstractObjective:Dietary acid load (DAL) might contribute to change the levels of cardiometabolic risk factors; however, the results are conflicting. The present review was conducted to determine the relationship between DAL and cardiometabolic risk factors.Design:Systematic review and meta-analysis.Setting:A systematic search was conducted in electronic databases including ISI Web of Science, PubMed/MEDLINE, Scopus and Google Scholar for observational studies which assessed cardiometabolic risk factors across DAL. Outcomes were lipid profile, glycaemic factors and anthropometric indices. Effect sizes were derived using a fixed- or random-effect model (DerSimonian–Laird). Also, subgroup analysis was performed to find the probable source of heterogeneity. Egger’s test was performed for finding any publication bias.Results:Thirty-one studies were included in the current review with overall sample size of 92 478. There was a significant relationship between systolic blood pressure (SBP; weighted mean difference (WMD) = 1·74 (95 % CI 0·25, 3·24) mmHg;P= 0·022;I2= 95·3 %), diastolic blood pressure (DBP; WMD = 0·75 (95 % CI 0·07, 1·42) mmHg;P= 0·030;I2= 80·8 %) and DAL in cross-sectional studies. Serum lipids, glycaemic parameters including fasting blood sugar, glycated Hb, serum insulin, homeostatic model assessment of insulin resistance and waist circumference had no significant relationship with DAL. No publication bias was found. BMI was not associated with DAL in both cross-sectional and cohort studies.Conclusions:Higher DAL is associated with increased SBP and DBP. More studies are needed to find any relationship of DAL with lipid profile and glycaemic factors.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
S Metintaş ◽  
M F Önsüz

Abstract Background The aim of the study was to perform a systematic review and meta-analysis of studies about the proportion of recognition of fecal occult blood test (FOBT) and colonoscopy (CS) methods and participation to them in any period of life for colorectal cancer (CRC) screening in Turkey. Methods PubMed, Web of Science, Google Scholar, Turkey Citation Index and YOK Thesis Center databases were screened both in Turkish and English language to identify relevant studies and key words ’colorectal cancer’, ’colon cancer’, ’cancer screening’, ’information’, ’attitude’, ’behavior’, ’awareness’ and ’Turkey’ were. Criteria for inclusion in the analysis were; conducted in Turkey, original and cross-sectional, conducted CRC risky groups (having CRC in the first degree patients and 50 and above age), studies that give the number of participants and number of taking FOBT and CS screening in any period of their lives and/or the number of knowing them. The studies that met the criteria were read as double blind. The data were entered into the Open Meta Analyst demo program. Because of p &lt; 0.001 in the heterogeneity test, random effects model was used in group analysis of the articles. The proportion and 95% confidence interval of knowing and taking FOBT and CS were calculated from the total number of cases. Results A total of 1176 articles were reached in first review. Duplications and inappropriated studies were eliminated, and 52 studies were selected. Eight studies about recognition FOBT, 16 about participation FOBT, 9 about recognition CS and 17 about participation CS were taken in analysis. After analysis it was found that 1315 of 4334 individuals (19.3%, 95%CI:6.6-32.1) recognized to FOBT, 1174 of 6825 individuals (13.2%, 8.0-18.5) participated to FOBT, 2197 of 5728 individuals (31.7%, 18.2-45.2) recognized to CS and 913 of 8860 individuals (10.0%, 8.1-12.0) participated to CS. Conclusions The proportion of recognition and participation to FOBT and CS were found less than expected. Key messages The proportion of recognition and participation CRC screening methods is low in risky groups. Awareness and participation of screening should be increased in risky groups.


2019 ◽  
Vol 42 (7) ◽  
pp. 567-576
Author(s):  
Shan Hu ◽  
Songbo Jing ◽  
Yixuan Gao

This systematic review and meta-analysis aimed to examine the effect of sleep restriction on blood pressure (BP) among healthy adults. Randomized controlled trials (RCTs) using partial sleep deprivation were included. The pooled effect size was calculated by the inverse variance method, and forest plot was used. Six studies were included (n = 10–43). Only one study obtained continuous BP readings. Overall, sleep restriction did not result in significant changes in systolic blood pressure (SBP) or diastolic blood pressure (DBP) and heart rate (HR). The respective weighted mean difference (MD) was 1.0 mmHg (95%CI, -2.3–4.2; p = 0.57), -0.4 mmHg (95%CI, -3.2–2.4; p = 0.80), and 2.0 bpm (95%CI, -2.2–6.2; p = 0.34). There is preliminary evidence suggesting that sleep restriction might affect sympathetic/parasympathetic modulation of cardiac autonomy and the inflammatory system. In this review, we did not find significant effects of sleep restriction on BP or HR measured by cross-sectional methods. More studies are warranted to confirm these findings by using continuous monitoring.


2019 ◽  
Vol 53 (10) ◽  
pp. 1033-1041 ◽  
Author(s):  
Erin N. Maxwell ◽  
Brittany Johnson ◽  
Joseph Cammilleri ◽  
Jason A. Ferreira

Objective: Recent literature suggests that intravenous (IV) administration may cause hypotension in hospitalized patients; data further suggest that this effect is most pronounced in the critically ill. The purpose of this review is to identify and evaluate current literature that addresses the incidence and implications of IV acetaminophen–induced hypotension. Data Sources: A literature search of MEDLINE, Cochrane, and EMBASE databases was performed (2002-2019) using the following terms: acetaminophen, paracetamol, intravenous, and hypotension. Abstracts and peer-reviewed publications were reviewed. Study Selection and Data Extraction: Relevant English-language studies conducted in humans evaluating the hemodynamic effects of IV acetaminophen were considered. Data Synthesis: A majority of the 19 studies included in this review identified a statistically significant drop in hemodynamic variables after the administration of 500 to 1000 mg IV acetaminophen as measured by changes in systolic blood pressure, diastolic blood pressure, or mean arterial pressure. Of the trials reporting vasopressor use, the authors found a significant increase in vasopressor requirements following IV acetaminophen administration. Relevance to Patient Care and Clinical Practice: This review represents the first comprehensive review of IV acetaminophen-induced hypotension. The findings raise the question of whether IV acetaminophen is an appropriate choice for inpatient pain or temperature management in the critically ill. Conclusions: Available evidence indicates that the administration of IV acetaminophen may be harmful in the critically ill. Additional monitoring is likely required when using IV acetaminophen in this specific population, particularly if a patient is hemodynamically unstable prior to administration.


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