Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies.
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
01 04 2021
01 04 2021
Historique:
pubmed:
17
10
2020
medline:
16
10
2021
entrez:
16
10
2020
Statut:
ppublish
Résumé
To conduct a systematic review and meta-analysis investigating effects of MedDiet on blood pressure in randomized controlled trials (RCTs) and associations of MedDiet with risk of hypertension in observational studies. PubMed, The Cochrane Library and EBSCOhost were searched from inception until January 2020 for studies that met the following criteria: participants aged at least 18 years, RCTs investigating effects of a MedDiet versus control on BP, observational studies exploring associations between MedDiet adherence and risk of hypertension. Random-effects meta-analyses were conducted. Meta-regression and subgroup analyses were performed for RCTs to identify potential effect moderators. Nineteen RCTs reporting data on 4137 participants and 16 observational studies reporting data on 59 001 participants were included in the meta-analysis. MedDiet interventions reduced SBP and DBP by a mean -1.4 mmHg (95% CI: -2.40 to -0.39 mmHg, P = 0.007, I2 = 53.5%, Q = 44.7, τ2 = 1.65, df = 19) and -1.5 mmHg (95% CI: -2.74 to -0.32 mmHg, P = 0.013, I2 = 71.5%, Q = 51.6, τ2 = 4.72, df = 19) versus control, respectively. Meta-regression revealed that longer study duration and higher baseline SBP was associated with a greater decrease in BP, in response to a MedDiet (P < 0.05). In observational studies, odds of developing hypertension were 13% lower with higher versus lower MedDiet adherence (95% CI: 0.78--0.98, P = 0.017, I2 = 69.6%, Q = 41.1, τ2 = 0.03, df = 17). Data suggest that MedDiet is an effective dietary strategy to aid BP control, which may contribute towards the lower risk of CVD reported with this dietary pattern. This study was registered with PROSPERO: CRD42019125073.
Identifiants
pubmed: 33060448
pii: 00004872-202104000-00021
doi: 10.1097/HJH.0000000000002667
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
729-739Subventions
Organisme : Medical Research Council
ID : MR/P020941/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T001852/1
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Références
Ezzati M, Riboli E. Behavioral and Dietary risk factors for noncommunicable diseases. N Engl J Med 2013; 369:954–964.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2224–2260.
Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet 2017; 390:2673–2734.
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control. Clinical perspective: a systematic analysis of population-based studies from 90 countries. Circulation 2016; 134:441–450.
Abbasnezhad A, Falahi E, Gonzalez MJ, Kavehi P, Fouladvand F, Choghakhori R. Effect of different dietary approaches compared with a regular diet on systolic and diastolic blood pressure in patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract 2020; 163:108108.
Siervo M, Scialò F, Shannon OM, Stephan BCM, Ashor AW. Does dietary nitrate say NO to cardiovascular ageing? Current evidence and implications for research. Proc Nutr Soc 2018; 77:112–123.
Ashor AW, Shannon OM, Werner A-D, Scialo F, Gilliard CN, Cassel KS, et al. Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: a randomised double-blind crossover trial. Clin Nutr 2020; 39:708–717.
Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 2011; 14:2274–2284.
Shannon OM, Stephan BCM, Granic A, Lentjes M, Hayat S, Mulligan A, et al. Mediterranean diet adherence and cognitive function in older UK adults: the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study. Am J Clin Nutr 2019; 110:938–948.
Alvarez León EE, Henríquez P, Serra-Majem L. Mediterranean diet and metabolic syndrome: a cross-sectional study in the Canary Islands. Public Health Nutr 2006; 9:1089–1098.
Jackson JK, MacDonald-Wicks LK, McEvoy MA, Forder PM, Holder C, Oldmeadow C, et al. Better diet quality scores are associated with a lower risk of hypertension and nonfatal CVD in middle-aged Australian women over 15 years of follow-up. Public Health Nutr 2020; 23:882–893.
La Verde ML, Mulè S, Zappalà G, Privitera G, Maugeri G, Pecora F, et al. Higher adherence to the Mediterranean diet is inversely associated with having hypertension: is low salt intake a mediating factor? Int J Food Sci Nutr 2018; 69:235–244.
Sánchez-Taínta A, Estruch R, Bulló M, Corella D, Gómez-Gracia E, Fiol M, et al. Adherence to a Mediterranean-type diet and reduced prevalence of clustered cardiovascular risk factors in a cohort of 3,204 high-risk patients. Eur J Cardiovasc Prev Rehabil 2008; 15:589–593.
Davis CR, Hodgson JM, Woodman R, Bryan J, Wilson C, Murphy KJ. A Mediterranean diet lowers blood pressure and improves endothelial function: results from the MedLey randomized intervention trial. Am J Clin Nutr 2017; 105:1305–1313.
Jennings A, Berendsen AM, de Groot LCPGM, Feskens EJM, Brzozowska A, Sicinska E, et al. Mediterranean-style diet improves systolic blood pressure and arterial stiffness in older adults. Hypertension 2019; 73:578–586.
Casas R, Sacanella E, Urpí-Sardà M, Corella D, Castañer O, Lamuela-Raventos R-M, et al. Long-term immunomodulatory effects of a Mediterranean diet in adults at high risk of cardiovascular disease in the PREvención con DIeta MEDiterránea (PREDIMED) randomized controlled trial. J Nutr 2016; 146:1684–1693.
Vincent-Baudry S, Defoort C, Gerber M, Bernard M-C, Verger P, Helal O, et al. The Medi-RIVAGE study: reduction of cardiovascular disease risk factors after a 3-mo intervention with a Mediterranean-type diet or a low-fat diet. Am J Clin Nutr 2005; 82:964–971.
Properzi C, O'Sullivan TA, Sherriff JL, Ching HL, Jeffrey GP, Buckley RF, et al. Ad libitum Mediterranean and low-fat diets both significantly reduce hepatic steatosis: a randomized controlled trial. Hepatology 2018; 68:1741–1754.
Rogerson D, Maçãs D, Milner M, Liu Y, Klonizakis M. Contrasting effects of short-term Mediterranean and vegan diets on microvascular function and cholesterol in younger adults: a comparative pilot study. Nutrients 2018; 10:1897.
Assaf-Balut C, García de la Torre N, Duran A, Fuentes M, Bordiú E, del Valle L, et al. A Mediterranean Diet with an enhanced consumption of extra virgin olive oil and pistachios improves pregnancy outcomes in women without gestational diabetes mellitus: a sub-analysis of the St. Carlos gestational diabetes mellitus prevention study. Ann Nutr Metab 2019; 74:69–79.
Faraoni D, Schaefer ST. Randomized controlled trials vs. observational studies: why not just live together? BMC Anesthesiol 2016; 16:102.
Black N. Why we need observational studies to evaluate the effectiveness of healthcare. BMJ 1996; 312:1215–1218.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339:b2700.
Higgins JPT, Green SE. Cochrane handbook for systematic reviews of interventions version 5.1.0. London, UK: The Cochrane Collaboration; 2011.
Islam MDM, Iqbal U, Walther B, Atique S, Dubey NK, Nguyen PA, et al. Benzodiazepine use and risk of dementia in the elderly population: a systematic review and meta-analysis. Neuroepidemiology 2016; 47:181–191.
Modesti PA, Reboldi G, Cappuccio FP, Agyemang C, Remuzzi G, Rapi S, et al. ESH Working Group on CV Risk in Low Resource Settings. Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLoS One 2016; 11:e0147601.
Viechtbauer W. Conducting meta-analyses in R with the metafor Package. J Statis Soft 2010; 36:1–48.
R Core Team. A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. 2020.
Osella AR, Colaianni G, Correale M, Pesole PL, Bruno I, Buongiorno C, et al. Irisin serum levels in metabolic syndrome patients treated with three different diets: a posthoc analysis from a randomized controlled clinical trial. Nutrients 2018; 10:844.
Toledo E, Hu FB, Estruch R, Buil-Cosiales P, Corella D, Salas-Salvadó J, et al. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial. BMC Med 2013; 11:207.
Doménech M, Roman P, Lapetra J, García de la Corte FJ, Sala-Vila A, de la Torre R, et al. Mediterranean diet reduces 24-h ambulatory blood pressure, blood glucose, and lipids: one-year randomized, clinical trial. Hypertension 2014; 64:69–76.
Ceriello A, Esposito K, La Sala L, Pujadas G, De Nigris V, Testa R, et al. The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report. Cardiovasc Diabetol 2014; 13:140.
Maiorino MI, Bellastella G, Petrizzo M, Gicchino M, Caputo M, Giugliano D, et al. Effect of a Mediterranean diet on endothelial progenitor cells and carotid intima-media thickness in type 2 diabetes: follow-up of a randomized trial. Eur J Prev Cardiol 2017; 24:399–408.
Ryan MC, Itsiopoulos C, Thodis T, Ward G, Trost N, Hofferberth S, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with nonalcoholic fatty liver disease. J Hepatol 2013; 59:138–143.
Tuttle KR, Shuler LA, Packard DP, Milton JE, Daratha KB, Bibus DM, Short RA. Comparison of low-fat versus Mediterranean-style dietary intervention after first myocardial infarction (from The Heart Institute of Spokane Diet Intervention and Evaluation Trial). Am J Cardiol 2008; 101:1523–1530.
Itsiopoulos C, Brazionis L, Kaimakamis M, Cameron M, Best JD, O’Dea K, et al. Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutr Metab Cardiovasc Dis 2011; 21:740–747.
Lorgeril Mde, Renaud S, Salen P, Monjaud I, Mamelle N, Martin JL, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343:1454–1459.
Lee J, Pase M, Pipingas A, Raubenheimer J, Thurgood M, Villalon L, et al. Switching to a 10-day Mediterranean-style diet improves mood and cardiovascular function in a controlled crossover study. Nutrition 2015; 31:647–652.
Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292:1440–1446.
Jospe MR, Roy M, Brown RC, Haszard JJ, Meredith-Jones K, Fangupo LJ, et al. Intermittent fasting, paleolithic, or mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise. Am J Clin Nutr 2020; 111:503–514.
Bajerska J, Chmurzynska A, Muzsik A, Krzyżanowska P, Mądry E, Malinowska AM, et al. Weight loss and metabolic health effects from energy-restricted Mediterranean and Central-European diets in postmenopausal women: A randomized controlled trial. Sci Rep 2018; 8:11170.
Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008; 359:229–241.
Panagiotakos DB, Pitsavos C, Stefanadis C. Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 2006; 16:559–568.
Martínez-González MÁ, Corella D, Salas-Salvadó J, Ros E, Covas MI, Fiol M, et al. PREDIMED Study Investigators. Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol 2012; 41:377–385.
Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348:2599–2608.
Trichopoulou A, Orfanos P, Norat T, Bueno-de-Mesquita B, Ocké MC, Peeters PH, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 2005; 330:991.
Cherfan M, Blacher J, Asmar R, Chahine MN, Zeidan RK, Farah R, Salameh P. Prevalence and risk factors of hypertension: a nationwide cross-sectional study in Lebanon. J Clin Hypertens 2018; 20:867–879.
Grosso G, Stepaniak U, Micek A, Topor-Mądry R, Stefler D, Szafraniec K, et al. A Mediterranean-type diet is associated with better metabolic profile in urban Polish adults: results from the HAPIEE study. Metabolism 2015; 64:738–746.
Stefler D, Malyutina S, Kubinova R, Pajak A, Peasey A, Pikhart H, et al. Mediterranean diet score and total and cardiovascular mortality in Eastern Europe: The HAPIEE study. Eur J Nutr 2017; 56:421–429.
Kanauchi M, Kanauchi K. Diet quality and adherence to a healthy diet in Japanese male workers with untreated hypertension. BMJ Open 2015; 5:e008404.
Karageorgou D, Magriplis E, Bakogianni I, Mitsopoulou AV, Dimakopoulos I, Micha R, et al. HNNHS Contributors, HNNHS Advisory Committee. Dietary patterns and cardiovascular disease in Greek adults: the Hellenic National Nutrition and Health Survey (HNNHS). Nutr Metab Cardiovasc Dis 2020; 30:201–213.
Vicinanza R, Troisi G, Cangemi R, De Martino MU, Pastori D, Bernardini S, et al. Aging and adherence to the Mediterranean diet: relationship with cardiometabolic disorders and polypharmacy. J Nutr Health Aging 2018; 22:73–81.
Díaz-Gutiérrez J, Ruiz-Estigarribia L, Bes-Rastrollo M, Ruiz-Canela M, Martin-Moreno JM, Martínez-González MA. The role of lifestyle behaviour on the risk of hypertension in the SUN cohort: the hypertension preventive score. Prev Med 2019; 123:171–178.
Alvarez-Alvarez I, Toledo E, Lecea O, Salas-Salvadó J, Corella D, Buil-Cosiales P, et al. Adherence to a priori dietary indexes and baseline prevalence of cardiovascular risk factors in the PREDIMED-Plus randomised trial. Eur J Nutr 2020; 59:1219–1232.
Foscolou A, Polychronopoulos E, Paka E, Tyrovolas S, Bountziouka V, Zeimbekis A, et al. Lifestyle and health determinants of cardiovascular disease among Greek older adults living in Eastern Aegean Islands: an adventure within the MEDIS study. Hellenic J Cardiol 2016; 57:407–414.
Georgousopoulou EN, Mellor DD, Naumovski N, Polychronopoulos E, Tyrovolas S, Piscopo S, et al. MEDIS study group. Mediterranean lifestyle and cardiovascular disease prevention. Cardiovasc Diagn Ther 2017; 7: (Suppl): S39–S47.
Tyrovolas S, Haro JM, Polychronopoulos E, Mariolis A, Piscopo S, Valacchi G, et al. Factors associated with components of arterial pressure among older individuals (the multinational MEDIS study): the role of the Mediterranean diet and alcohol consumption. J Clin Hypertens (Greenwich) 2014; 16:645–651.
Heindel J, Baid-Agrawal S, Rebholz CM, Nadal J, Schmid M, Schaeffner E, et al. GCKD Study Investigators. Association between dietary patterns and kidney function in patients with chronic kidney disease: a cross-sectional analysis of the German chronic kidney disease study. J Ren Nutr 2019; 2276:30347–30354.
Nissensohn M, Román-Viñas B, Sánchez-Villegas A, Piscopo S, Serra-Majem L. The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis. J Nutr Educ Behav 2016; 48:42.e1–53.e1.
Ndanuko RN, Tapsell LC, Charlton KE, Neale EP, Batterham MJ. Dietary patterns and blood pressure in adults: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr 2016; 7:76–89.
Gay HC, Rao SG, Vaccarino V, Ali MK. Effects of different dietary interventions on blood pressure: systematic review and meta-analysis of randomized controlled trials. Hypertension 2016; 67:733–739.
Schwingshackl L, Chaimani A, Schwedhelm C, Toledo E, Pünsch M, Hoffmann G, et al. Comparative effects of different dietary approaches on blood pressure in hypertensive and prehypertensive patients: a systematic review and network meta-analysis. Crit Rev Food Sci Nutr 2019; 59:2674–2687.
Kiefer C, Sturtz S, Bender R. Indirect comparisons and network meta-analyses. Dtsch Arztebl Int 2015; 112:803–808.
Rees K, Takeda A, Martin N, Ellis L, Wijesekara D, Vepa A, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2019; 13:CD009825.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. The Lancet 2002; 360:1903–1913.
Shannon OM, Mendes I, Köchl C, Mazidi M, Ashor AW, Rubele S, et al. Mediterranean diet increases endothelial function in adults: a systematic review and meta-analysis of randomized controlled trials. J Nutr 2020; 150:1151–1159.
Shannon OM, Stephan BCM, Minihane AM, Mathers JC, Siervo M. Nitric oxide boosting effects of the Mediterranean diet: a potential mechanism of action. J Gerontol A Biol Sci Med Sci 2018; 73:902–904.
Ambring A, Friberg P, Axelsen M, Laffrenzen M, Taskinen M-R, Basu S, Johansson M. Effects of a Mediterranean-inspired diet on blood lipids, vascular function and oxidative stress in healthy subjects. Clin Sci (Lond) 2004; 106:519–525.
Filippis FD, Pellegrini N, Vannini L, Jeffery IB, Storia AL, Laghi L, et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut 2016; 65:1812–1821.
Larsen FJ, Ekblom B, Sahlin K, Lundberg JO, Weitzberg E. Effects of dietary nitrate on blood pressure in healthy volunteers. N Engl J Med 2006; 355:2792–2793.
Siervo M, Shannon O, Kandhari N, Prabhakar M, Fostier W, Köchl C, et al. Nitrate-rich beetroot juice reduces blood pressure in Tanzanian adults with elevated blood pressure: A double-blind randomized controlled feasibility trial. J Nutr 2020; 150:2460–2468.
Jackson JK, Patterson AJ, MacDonald-Wicks LK, Oldmeadow C, McEvoy MA. The role of inorganic nitrate and nitrite in cardiovascular disease risk factors: a systematic review and meta-analysis of human evidence. Nutr Rev 2018; 76:348–371.
Bao DQ, Mori TA, Burke V, Puddey IB, Beilin LJ. Effects of dietary fish and weight reduction on ambulatory blood pressure in overweight hypertensives. Hypertension 1998; 32:710–717.
Ordovas JM, Ferguson LR, Tai ES, Mathers JC. Personalised nutrition and health. BMJ 2018. 361bmj.k2173.
Hodgkinson J, Mant J, Martin U, Guo B, Hobbs FDR, Deeks JJ, et al. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ 2011. 342.