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Cited by 530Nutritional Studies and DietBlood Pressure and Hypertension StudiesSodium Intake and Health

Vegetarian Diets and Blood Pressure: A Meta-analysis

Yokoyama, Yoko, Nishimura, Kunihiro, Barnard, Neal D., Takegami, Misa, Watanabe, Makoto, Sekikawa, Akira, Okamura, Tomonori, Miyamoto, Yoshihiro·2014·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2013.14547
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Abstract

IMPORTANCE Previous studies have suggested an association between vegetarian diets and lower blood pressure (BP), but the relationship is not well established. OBJECTIVE To conduct a systematic review and meta-analysis of controlled clinical trials and observational studies that have examined the association between vegetarian diets and BP. DATA SOURCES MEDLINE and Web of Science were searched for articles published in English from 1946 to October 2013 and from 1900 to November 2013, respectively. STUDY SELECTION All studies met the inclusion criteria of the use of (1) participants older than 20 years, (2) vegetarian diets as an exposure or intervention, (3) mean difference in BP as an outcome, and (4) a controlled trial or observational study design. In addition, none met the exclusion criteria of (1) use of twin participants, (2) use of multiple interventions, (3) reporting only categorical BP data, or (4) reliance on case series or case reports. DATA EXTRACTION AND SYNTHESIS Data collected included study design, baseline characteristics of the study population, dietary data, and outcomes. The data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES Net differences in systolic and diastolic BP associated with the consumption of vegetarian diets were assessed. RESULTS Of the 258 studies identified, 7 clinical trials and 32 observational studies met the inclusion criteria. In the 7 controlled trials (a total of 311 participants; mean age, 44.5 years), consumption of vegetarian diets was associated with a reduction in mean systolic BP (-4.8 mm Hg; 95% CI, -6.6 to -3.1; P < .001; I2 = 0; P = .45 for heterogeneity) and diastolic BP (-2.2 mm Hg; 95% CI, -3.5 to -1.0; P < .001; I2 = 0; P = .43 for heterogeneity) compared with the consumption of omnivorous diets. In the 32 observational studies (a total of 21,604 participants; mean age, 46.6 years), consumption of vegetarian diets was associated with lower mean systolic BP (-6.9 mm Hg; 95% CI, -9.1 to -4.7; P < .001; I2 = 91.4; P < .001 for heterogeneity) and diastolic BP (-4.7 mm Hg; 95% CI, -6.3 to -3.1; P < .001; I2 = 92.6; P < .001 for heterogeneity) compared with the consumption of omnivorous diets. CONCLUSIONS AND RELEVANCE Consumption of vegetarian diets is associated with lower BP. Such diets could be a useful nonpharmacologic means for reducing BP.

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  • Randomized controlled trial evidence shows a protective effect of plant-based diets on intermediate outcomes, including weight change, lipid profile, glycemic control, and blood pressure.

    “Additionally, randomized controlled trial evidence showing the protective effect of plant-based diets on intermediate outcomes, including weight change, lipid profile, glycemic control, and blood pressure lends further support to our findings.(35–38)”

    From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [35]

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Authors
Yokoyama, Y., Nishimura, K., Barnard, N. D., Takegami, M., Watanabe, M., Sekikawa, A., Okamura, T., & Miyamoto, Y.
Affiliations
  • Physicians Committee for Responsible Medicine (US)
  • Fujita Health University (JP)
  • Kyoto University (JP)
  • National Cerebral and Cardiovascular Center (JP)
  • University of Pittsburgh (US)
  • Keio University (JP)
Corresponding author
Yokoyama, Yoko
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2014-04-01
Volume
174
Issue
4
Pages
577
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2013.14547
OpenAlex
W2007138293
Cited by
530
References
65
Citations by year
2026: 20 · 2025: 35 · 2024: 44 · 2023: 52 · 2022: 48 · 2021: 54 · 2020: 102 · 2019: 46 · 2018: 43 · 2017: 25 · 2016: 31 · 2015: 20 · 2014: 10
FWCI
28.40
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
vegetarian diet, blood pressure, systolic blood pressure, diastolic blood pressure, hypertension, dietary intervention, omnivorous diet, dietary habits, cardiovascular risk factors, dietary fiber, dietary fat, dietary sodium, dietary protein, dietary calcium, dietary magnesium, potassium intake, dietary iron, dietary zinc, vitamin C intake, vitamin D intake, dietary antioxidants, dietary polyphenols
MeSH terms
Blood Pressure, Humans, Hypertension, Diet, Vegetarian

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