得舒饮食模式预防高血压的meta分析

Meta-analysis on the effect of DASH diet for hypertension prevention

目的 用meta分析方法探究得舒(dietary approaches to stop hypertension, DASH)饮食模式对高血压的预防作用。方法 计算机检索并筛选PubMed、Web of Science、Cochrane、中国知网、万方以及维普等数据库,收集应用DASH饮食模式开展预防高血压的前瞻性队列研究(prospective cohort studies, PCS)或随机对照试验(randomized controlled trials, RCT),使用RevMan v5.3进行meta分析,借助随机效应模型合并均数差(MD)和95%置信区间(95%CI)。结果 共纳入研究文献7篇,其中包括1篇PCS和6篇RCT,共纳入研究对象2 903例,包括试验组对象1 485例和对照组对象1 418例。meta分析结果显示,DASH饮食对收缩压(systolic bloodpressure, SBP)(MD=-6.27 mmHg, 95%CI:-10.19~-2.34)和舒张压(diastolic blood pressure, DBP)(MD=-4.18 mmHg, 95%CI:-6.53~-1.84)均有显著的降压作用(ZSBP=3.13,PSBP<0.01;ZSBP=3.47,PDBP<0.01),且DASH饮食对SBP的降压作用较DBP更加明显(MD=-1.79 mmHg, 95%CI:-3.34~-0.24;Z=2.26,P=0.02)。结论 DASH饮食模式对高血压有一定的预防作用,且对SBP的降压作用大于DBP。

Objective To explore the effect of dietary approaches to stop hypertension(DASH)for preventing hypertension based on the meta-analysis.Methods Databases of PubMed,Web of Science,the Cochrane Library,CNKI,Wanfang Data,and VIP were searched and screened for prospective cohort studies(PCS)and randomized controlled trials(RCT)on the effect of DASH diet on hypertension prevention.The effect sizes were combined with a random-effect model,and then the meta-analysis was performed by using RevMan v5.3.Results Seven articles were enrolled in this study,including 1 PCS and 6 RCTs.2,903 subjects were involved,including 1,485 cases in the experimental group and 1,418 cases in the control group.The results of meta-analysis showed that DASH diet led to significantly greater reductions in systolic blood pressure(SBP,MD=-6.27 mmHg,95%CI:-10.19--2.34;ZSBP=3.13,PSBP<0.01)and diastolic blood pressure(DBP,MD=-4.18 mmHg,95%CI:-6.53--1.84;ZSBP=3.47,PDBP<0.01);moreover,DASH diet had a more pronounced hypotensive effect on SBP than DBP(MD=-1.79 mmHg,95%CI:-3.34--0.24;Z=2.26,P=0.02).Conclusion DASH diet has a preventive effect on hypertension and causes a more pronounced hypotensive effect on SBP.