Influence of weight reduction on blood pressure - A meta-analysis of randomized controlled trials
Influence of weight reduction on blood pressure - A meta-analysis of randomized controlled trials
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DOI：
10.1161/01.hyp.0000094221.86888.ae
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发表时间：
2003-11-01
期刊：
影响因子：
8.3
通讯作者：
Geleijnse, JM
中科院分区：
文献类型：
--
作者：
Neter, JE;Stam, BE;Geleijnse, JM
体重增加是高血压的一个重要危险因素。对随机对照试验进行荟萃分析，以估计体重减轻对总体和人群亚组血压的影响。纳入了1966年至2002年间发表的25项随机对照试验（包括34个分层），共纳入4874例受试者。随机效应模型用于解释试验间的异质性。通过能量限制、增加体力活动或两者同时进行，净体重减轻-5.1 kg（95%置信区间[CI]，-6.03至-4.25），收缩压降低-4.44 mmHg（95% CI，-5.93至-2.95），舒张压降低-3.57 mmHg（95% CI，-4.88至-2.25）。当以每千克体重减轻表示时，收缩压降低为-1.05 mmHg（95% CI，-1.43至-0.66），舒张压降低为-0.92 mmHg（95% CI，-1.28至-0.55）。正如预期的那样，在平均体重减轻>5 kg的人群中观察到的血压下降幅度明显大于体重减轻较少的人群，无论是收缩压还是舒张压，（-6.63 mmHg [95% CI，-8.43至-4.82] vs -2.70 mmHg [ 95% CI，-4.59至-0.81]）和舒张压（-5.12 mmHg [95% CI，-6.48至-3.75] vs -2.01 mmHg [95% CI，-3.47至-0.54]）血压。服用抗高血压药物的人群对舒张压的影响显著大于未接受治疗的人群（-5.31 mmHg [95% CI，-6.64至-3.99] vs -2.91 mmHg [95% CI，-3.66至-2.16]）。这项荟萃分析清楚地表明，减肥对预防和治疗高血压很重要。
Increased body weight is a strong risk factor for hypertension. A meta-analysis of randomized controlled trials was performed to estimate the effect of weight reduction on blood pressure overall and in population subgroups. Twenty-five randomized, controlled trials (comprising 34 strata) published between 1966 and 2002 with a total of 4874 participants were included. A random-effects model was used to account for heterogeneity among trials. A net weight reduction of -5.1 kg (95% confidence interval [CI], -6.03 to -4.25) by means of energy restriction, increased physical activity, or both reduced systolic blood pressure by -4.44 mm Hg (95% CI, -5.93 to -2.95) and diastolic blood pressure by -3.57 mm Hg (95% CI, -4.88 to -2.25). Blood pressure reductions were -1.05 mm Hg (95% CI, -1.43 to -0.66) systolic and -0.92 mm Hg (95% CI, -1.28 to -0.55) diastolic when expressed per kilogram of weight loss. As expected, significantly larger blood pressure reductions were observed in populations with an average weight loss >5 kg than in populations with less weight loss, both for systolic (-6.63 mm Hg [95% CI, -8.43 to -4.82] vs -2.70 mm Hg [ 95% CI, -4.59 to -0.81]) and diastolic (-5.12 mm Hg [95% CI, -6.48 to -3.75] vs -2.01 mm Hg [95% CI, -3.47 to -0.54]) blood pressure. The effect on diastolic blood pressure was significantly larger in populations taking antihypertensive drugs than in untreated populations (-5.31 mm Hg [95% CI, -6.64 to -3.99] vs -2.91 mm Hg [95% CI, -3.66 to -2.16]). This meta-analysis clearly shows that weight loss is important for the prevention and treatment of hypertension.