Effect of Religious Fasting in Ramadan on Blood Pressure: Results From LORANS (London Ramadan Study) and a Meta-Analysis.
Effect of Religious Fasting in Ramadan on Blood Pressure: Results From LORANS (London Ramadan Study) and a Meta-Analysis.
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DOI：
10.1161/jaha.120.021560
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发表时间：
2021-10-19
影响因子：
5.4
通讯作者：
Dehghan A
中科院分区：
文献类型：
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作者：
Al-Jafar R;Zografou Themeli M;Zaman S;Akbar S;Lhoste V;Khamliche A;Elliott P;Tsilidis KK;Dehghan A
每年有数亿人实行斋月禁食。这种仪式实践极大地改变了饮食和生活方式。因此，必须确定斋月禁食对血压的影响。 LORANS（伦敦斋月研究）是一项观察性研究、系统评价和荟萃分析。在 LORANS 中，我们在斋月前后测量了 85 名参与者的收缩压 (SBP) 和舒张压 (DBP)。在系统评价中，从 PubMed、Embase 和 Scopus 检索了从开始到 2020 年 3 月 3 日的研究。我们对这些研究和 LORANS 未发表数据的效果进行了荟萃分析。我们纳入了在斋月之前以及斋月最后 2 周或斋月后一个月的前 2 周测量收缩压和/或舒张压的观察性研究。数据评估和提取由至少 2 名评审员并行进行。我们使用随机效应模型汇总了收缩压和舒张压。系统评价已在 PROSPERO（国际前瞻性系统评价注册库；CRD42019159477）注册。 LORANS 招募了 85 名参与者；平均年龄为 45.6±15.9 岁，52.9% (n=45) 的参与者为男性。即使在对潜在混杂因素进行调整后，斋月禁食后的 SBP 和 DBP 仍降低了 7.29 mm Hg（-4.74 至 -9.84）和 3.42 mm Hg（-1.73 至 -5.09）。我们确定了 2778 项研究，其中纳入了 33 项、3213 名参与者。斋月前后的 SBP 和 DBP 分别降低 3.19 mm Hg（-4.43 至 -1.96，I2=48%）和 2.26 mm Hg（-3.19 至 -1.34，I2=66%）。在亚组分析中，在健康或患有高血压或糖尿病的人群中观察到血压较低，但在慢性肾病患者中却没有观察到。我们的研究表明，斋月禁食对血压的有益影响与体重、体内水分和脂肪量的变化无关，并支持一些政府指南的建议，这些指南将斋月禁食描述为一种与血压有关的安全宗教活动。
Ramadan fasting is practiced by hundreds of millions every year. This ritual practice changes diet and lifestyle dramatically; thus, the effect of Ramadan fasting on blood pressure must be determined. LORANS (London Ramadan Study) is an observational study, systematic review, and meta‐analysis. In LORANS, we measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 85 participants before and right after Ramadan. In the systematic review, studies were retrieved from PubMed, Embase, and Scopus from inception to March 3, 2020. We meta‐analyzed the effect from these studies and unpublished data from LORANS. We included observational studies that measured SBP and/or DBP before Ramadan and during the last 2 weeks of Ramadan or the first 2 weeks of the month after. Data appraisal and extraction were conducted by at least 2 reviewers in parallel. We pooled SBP and DBP using a random‐effects model. The systematic review is registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42019159477). In LORANS, 85 participants were recruited; mean age was 45.6±15.9 years, and 52.9% (n=45) of participants were men. SBP and DBP after Ramadan fasting were lower by 7.29 mm Hg (−4.74 to −9.84) and 3.42 mm Hg (−1.73 to −5.09), even after adjustment for potential confounders. We identified 2778 studies of which 33 with 3213 participants were included. SBP and DBP after/before Ramadan were lower by 3.19 mm Hg (−4.43 to −1.96, I2=48%) and 2.26 mm Hg (−3.19 to −1.34, I2=66%), respectively. In subgroup analyses, lower blood pressures were observed in the groups who are healthy or have hypertension or diabetes but not in patients with chronic kidney disease. Our study suggests beneficial effects of Ramadan fasting on blood pressure independent of changes in weight, total body water, and fat mass and supports recommendations for some governmental guidelines that describe Ramadan fasting as a safe religious practice with respect to blood pressure.