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Efficacy of nutritional recommendations given by registered dietitians
compared to other healthcare providers in reducing arterial blood pressure:
Systematic review and meta-analysis.
Clin Nutr. 2018 04;37(2):522-531
Authors: Riegel GR, Ribeiro PAB, Rodrigues MP, Zuchinali P, Moreira LB
Abstract
INTRODUCTION: The multidisciplinary health practitioners can facilitate
adherence to treatment of hypertension. Nutritional recommendations
delivered by an expert in nutrition might increase the blood pressure
control through a better comprehension about how nutrition plays a role on
hypertension.
OBJECTIVE: To evaluate the effect of nutritional intervention performed by
a multidisciplinary team with and without registered dietitians compared to
usual care in blood pressure control of hypertensive patients.
METHODOLOGY: Systematic review including randomized clinical trials that
assessed participants >18 years, both sexes, with blood pressure ≥140/90
mmHg or use of antihypertensive, ≥8 weeks duration and at least one
nutritional planned intervention versus usual care. The search was
conducted in July 2015 in MEDLINE, EMBASE, BIREME, Web of Science and
LILACS without limitation to language. Outcome was defined as deltas of
systolic (SBP) and diastolic blood pressure (DBP). Sub-group analysis was
conducted according to the presence or not of the registered dietitians in
the staff. The analyses were performed in RevMan 5.3 software, using random
effects model with heterogeneity assessed by statistical I2.
RESULTS: From 7280 identified titles, 62 studies were selected for data
extraction, and 13 were included in the meta-analysis, with a total of 2050
participants. There was a greater reduction in ΔSBP -2.82 mmHg (95% CI:
4.03 to -1.62) and ΔDBP -1.37 mmHg (95% CI: -2.11 to -0.62) when diet
recommendations have been delivered by multi-professional team versus usual
care. In stratified analyses only the subgroup of studies with registered
dietitians showed statistical significant reduction in blood pressure ΔSBP
-3.21 mmHg (95% CI: -4.14 to -2.27); ΔDBP -1.46 mmHg (95% CI: -2.06 to
-0.86). There were significant differences between the deltas of blood
pressure according to sodium restriction (ΔSBP -3.5 mmHg (95% CI: -4.52 to
-2.48), ΔDBP -1.69 mmHg (95% CI: -2.36 to -1, 02)) and caloric restriction
(ΔSBP -2.83 mmHg (95% CI: -5.11 to -0.54); ΔDBP -0.92 mmHg (95% CI: -2.21
to 0.37)) only when there was a registered dietitians in the
multidisciplinary team.
CONCLUSION: Nutritional recommendation made by multidisciplinary team has a
statistical significant effect on blood pressure control in hypertensive
patients, mainly when a registered dietitian is present in the team.
PMID: 28065482
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
<https://www.ncbi.nlm.nih.gov/home/about/policies>.
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