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Xu R, Yang K, Ding J, Chen G. Effect of green tea supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e19047. [PMID: 32028419 PMCID: PMC7015560 DOI: 10.1097/md.0000000000019047] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although evidence from animal and observational studies has supported the beneficial effects of green tea intake for lowering blood pressure (BP), randomized placebo-controlled trials (RCTs) have yielded conflicting results. In this meta-analysis of RCTs, we aimed to assess the effects of green tea supplementation on measures of BP control. METHODS The PubMed, Embase, and Cochrane Library databases were electronically searched from inception to August 2019 for all relevant studies. The results were pooled using the generic inverse-variance method with random-effects weighting and expressed as mean differences (MDs) with 95% confidence intervals (CIs). The quality of studies was assessed using the Jadad score. Publication bias was evaluated using funnel plots, Egger test, and Begg test. RESULTS Twenty-four trials with 1697 subjects were included in the meta-analysis. The pooled results showed that green tea significantly lowered systolic BP (SBP; MD: -1.17 mm Hg; 95%CI: -2.18 to -0.16mm Hg; P = .02) and diastolic BP (DBP; MD: -1.24 mm Hg; 95%CI:-2.07 to -0.40mm Hg; P = .004). Significant heterogeneity was found for both SBP (I = 43%) and DBP (I = 57%). In addition, no evidence of significant publication bias was found from funnel plots or Egger test (P = .674 and P = .270 for SBP and DBP, respectively). CONCLUSION Overall, green tea significantly reduced SBP and DBP over the duration of the short-term trials. Larger and longer-term trials are needed to further investigate the effects of green tea supplementation on BP control and clinical events.
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Affiliation(s)
| | - Ke Yang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Jie Ding
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Guangzhi Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
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To Stent or Not to Stent? Update on Revascularization for Atherosclerotic Renovascular Disease. Curr Hypertens Rep 2016; 18:45. [PMID: 27130448 DOI: 10.1007/s11906-016-0655-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Renal artery stenosis (RAS) is increasingly encountered in clinical practice. The two most common etiologies are fibromuscular dysplasia (FMD) and atherosclerotic renal artery disease (ARAS), with the latter accounting for the vast majority of cases. Significant RAS activates the renin-angiotensin-aldosterone system and is associated with three major clinical syndromes: ischemic nephropathy, hypertension, and destabilizing cardiac syndromes. Over the past two decades, advancements in diagnostic and interventional techniques have led to improved detection and the widespread use of endovascular renal artery revascularization strategies in the management of ARAS. However, renal artery stenting for ARAS remains controversial. Although several studies have demonstrated some benefit with renal artery revascularization, this has not been to the extent anticipated or predicted. Moreover, these trials have significant flaws in their study design and are hampered with inherent bias which make their interpretation challenging. In this review, we evaluate the existing body of evidence and offer an approach to the management of patients with ARAS in light of the current literature. From the data provided, identification of subgroup of patients, namely, those with a hemodynamically significant RAS in the context of progressive renal insufficiency and/or deteriorating arterial hypertension, seems possible and may derive clinical benefit from ARAS stent revascularization. Appropriate patient selection is therefore the key and more robust studies are required.
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Mohammadifard N, Salehi-Abargouei A, Salas-Salvadó J, Guasch-Ferré M, Humphries K, Sarrafzadegan N. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr 2015; 101:966-82. [PMID: 25809855 DOI: 10.3945/ajcn.114.091595] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 03/04/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although several studies have assessed the effects of nut consumption (tree nuts, peanuts, and soy nuts) on blood pressure (BP), the results are conflicting. OBJECTIVE The aim was to conduct a systematic review and meta-analysis of published randomized controlled trials (RCTs) to estimate the effect of nut consumption on BP. DESIGN The databases MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched for RCTs carried out between 1958 and October 2013 that reported the effect of consuming single or mixed nuts (including walnuts, almonds, pistachios, cashews, hazelnuts, macadamia nuts, pecans, peanuts, and soy nuts) on systolic BP (SBP) or diastolic BP (DBP) as primary or secondary outcomes in adult populations aged ≥18 y. Relevant articles were identified by screening the abstracts and titles and the full text. Studies that evaluated the effects for <2 wk or in which the control group ingested different healthy oils were excluded. Mean ± SD changes in SBP and DBP in each treatment group were recorded for meta-analysis. RESULTS Twenty-one RCTs met the inclusion criteria. Our findings suggest that nut consumption leads to a significant reduction in SBP in participants without type 2 diabetes [mean difference (MD): -1.29; 95% CI: -2.35, -0.22; P = 0.02] but not in the total population. Subgroup analyses of different nut types suggest that pistachios, but not other nuts, significantly reduce SBP (MD: -1.82; 95% CI: -2.97, -0.67; P = 0.002). Our study suggests that pistachios (MD: -0.80; 95% CI: -1.43, -0.17; P = 0.01) and mixed nuts (MD: -1.19; 95% CI: -2.35, -0.03; P = 0.04) have a significant reducing effect on DBP. We found no significant changes in DBP after the consumption of other nuts. CONCLUSIONS Total nut consumption lowered SBP in participants without type 2 diabetes. Pistachios seemed to have the strongest effect on reducing SBP and DBP. Mixed nuts also reduced DBP.
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Affiliation(s)
- Noushin Mohammadifard
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Amin Salehi-Abargouei
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Jordi Salas-Salvadó
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Marta Guasch-Ferré
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Karin Humphries
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
| | - Nizal Sarrafzadegan
- From the Isfahan Cardiovascular Research Center (NM and NS), the Hypertension Research Center (NM), Isfahan Cardiovascular Research Institute and the Food Security Research Center (AS-A), Isfahan University of Medical Sciences, Isfahan, Iran; the Nutrition and Food Security Research Center (AS-A) and the Department of Nutrition, Faculty of Health (AS-A), Shahid Sadoughi University of Medical Sciences, Yazd, Iran; the Human Nutrition Unit, Department of Biochemistry and Biotechnology, IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition, Reus, Spain (JS-S and MG-F); and Cardiology Division, Department of Medicine, University of British Columbia, Vancouver, Canada (KH)
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Tomiyama H, Matsumoto C, Kimura K, Odaira M, Shiina K, Yamashina A. Pathophysiological contribution of vascular function to baroreflex regulation in hypertension. Circ J 2014; 78:1414-9. [PMID: 24694767 DOI: 10.1253/circj.cj-14-0064] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND We examined which pathophysiological abnormalities of vascular function might be closely associated with abnormal baroreflex regulation in subjects with hypertension. METHODS AND RESULTS In the cross-sectional assessment, 280 subjects with hypertension were enrolled for measurement of brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), flow-mediated vasodilatation (FMD) of the brachial artery and baroreceptor sensitivity (BRS). These parameters were measured again as prospective assessment in some of these subjects. In the cross-sectional assessment, after adjustment for confounding variables including anti-hypertensive medication, the baPWV, but not the rAI or FMD, was found to have a significant independent relationship with BRS (standardization coefficient, -0.149, P<0.043). In the subjects who were newly started on anti-hypertensive medication (n=40), regression of baPWV before and 1 year after the start of medication was significantly associated with change in BRS during the same period. In subjects already on anti-hypertensive medication (n=92) also, the evolutional change of baPWV over a follow-up period >1.5 years was significantly associated with change in BRS during the same period. CONCLUSIONS Increased stiffness of the large- to middle-sized arteries, rather than abnormal central hemodynamics or endothelial dysfunction, appears to contribute to abnormal baroreflex regulation in patients with hypertension.
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