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Meta-Analysis
. 2016 Jan 15;7(1):76-89.
doi: 10.3945/an.115.009753. Print 2016 Jan.

Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Rhoda N Ndanuko  1 , Linda C Tapsell  2 , Karen E Charlton  2 , Elizabeth P Neale  2 , Marijka J Batterham  3
Affiliations
Meta-Analysis

Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Rhoda N Ndanuko et al. Adv Nutr. .

Abstract

Hypertension is a major risk factor for developing cardiovascular disease, stroke, and kidney disease. To lower blood pressure (BP), several lifestyle changes are recommended such as weight loss, exercise, and following a healthy diet. Investigating the effect of single nutrients may have positive results, but food is consumed as part of a whole diet, resulting in nutrient interactions. The aim of this systematic review and meta-analysis was to assess the effect of dietary patterns on BP in adults. Studies that were published between January 1999 and June 2014 were retrieved using Scopus, Web of Science, and the MEDLINE database. Seventeen randomized controlled trials were included in the meta-analysis. The results suggest that healthy dietary patterns such as the Dietary Approaches to Stop Hypertension diet, Nordic diet, and Mediterranean diet significantly lowered systolic BP and diastolic BP by 4.26 mm Hg and 2.38 mm Hg, respectively. These diets are rich in fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy and low in meat, sweets, and alcohol. Lifestyle factors such as exercise and weight loss in combination with dietary changes may also reduce BP. Further research is needed to establish the effect of dietary patterns on BP in different cultures other than those identified in this review. The review was registered on PROSPERO (International prospective register of systematic reviews) as CRD42015016272.

Keywords: DASH diet; Mediterranean diet; Nordic diet; blood pressure; dietary patterns; healthy diet; hypertension.

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Conflict of interest statement

Author disclosures: RN Ndanuko, LC Tapsell, KE Charlton, EP Neale, MJ Batterham, no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Preferred reporting items for systematic reviews and meta-analyses flow diagram. BP, blood pressure.
FIGURE 2
FIGURE 2
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
FIGURE 3
FIGURE 3
Forest plot of effect of the different dietary patterns in 17 randomized controlled trials on systolic blood pressure (mm Hg). DASH, Dietary Approaches to Stop Hypertension; IV, inverse variance.
FIGURE 4
FIGURE 4
Forest plot of effect of the different dietary patterns in 17 randomized controlled trials on diastolic blood pressure (mm Hg). DASH, Dietary Approaches to Stop Hypertension; IV, inverse variance.
FIGURE 5
FIGURE 5
Forest plot of effect of dietary patterns on systolic blood pressure (mm Hg) according to different interventions such as weight loss, exercise, and sodium restriction. IV, inverse variance.
FIGURE 6
FIGURE 6
Forest plot of effect of dietary patterns on diastolic blood pressure (mm Hg) according to different interventions such as weight loss, exercise, and sodium restriction. IV, inverse variance.
See this image and copyright information in PMC

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