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Effect of Dietary Pulses on Blood Pressure: A Systematic Review and Meta-analysis of Controlled Feeding Trials
Open accessAbstract
BACKGROUND: Current guidelines recommend diet and lifestyle modifications for primary prevention and treatment of hypertension, but do not encourage dietary pulses specifically for lowering blood pressure (BP). To quantify the effect of dietary pulse interventions on BP and provide evidence for their inclusion in dietary guidelines, a systematic review and meta-analysis of controlled feeding trials was conducted. METHODS: MEDLINE, EMBASE, Cochrane Library, and CINAHL were each searched from inception through 5 May 2013. Human trials ≥3 weeks that reported data for systolic, diastolic, and/or mean arterial BPs were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias of included studies. Effect estimates were pooled using random effects models, and reported as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (χ(2) test) and quantified (I(2)). RESULTS: Eight isocaloric trials (n = 554 participants with and without hypertension) were included in the analysis. Dietary pulses, exchanged isocalorically for other foods, significantly lowered systolic (MD = -2.25 mm Hg (95% CI, -4.22 to -0.28), P = 0.03) and mean arterial BP (MD = -0.75 mm Hg (95% CI, -1.44 to -0.06), P = 0.03), and diastolic BP non-significantly (MD = -0.71 mm Hg (95% CI, -1.74 to 0.31), P = 0.17). Heterogeneity was significant for all outcomes. CONCLUSIONS: Dietary pulses significantly lowered BP in people with and without hypertension. Higher-quality large-scale trials are needed to support these findings. CLINICAL TRIAL REGISTRATION: NCT01594567.
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In the citing paper
“Systematic reviews and meta-analyses of randomized controlled trials of viscous fibre 48,49 as well as total dietary fibre (inclusive of viscous fibre) 50 and sources of plant protein including dietary pulses and soy protein, have shown reductions in SBP/DBP 51,52 .”
From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [51]
Experimental — accuracy not yet measuredIn the citing paper
“Legumes also reduce SBP (by 2 mmHg) and lowered mean arterial pressure(231) in a meta-analysis of eight RCTs.”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [231]
In the citing paper
“In observational studies and RCTs consumption of legumes improves CVD risk factors, such as waist circumference, cholesterol, BP, C-reactive protein, glucose; and is protective against T2DM (224–231).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [231]
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure
Appel, L. J., Moore, T. J., Obarzanek, E., Vollmer, W. M., Svetkey, L. P., Sacks, F. M., Bray, G. A., Vogt, T. M., Cutler, J. A., Windhauser, M. M., et al. (1997) · New England Journal of Medicine · doi:10.1056/nejm199704173361601 · Cited by 5,981
Mancia, G., Fagard, R., Narkiewicz, K., Redón, J., Zanchetti, A., Böhm, M., Christiaens, T., Cifkova, R., De Backer, G., Dominiczak, A., et al. (2013) · Journal of Hypertension · doi:10.1097/01.hjh.0000431740.32696.cc · Cited by 5,655
Research works printed but not linked: 1
- Diao, 2012, Cochrane database of systematic reviews (Online), 8, CD006742
Cited by
Sorted by citations
Chiavaroli, L., Viguiliouk, E., Nishi, S., Blanco Mejia, S., Rahelić, D., Kahleová, H., Salas-Salvadó, J., Kendall, C., & Sievenpiper, J. (2019) · Nutrients · doi:10.3390/nu11020338 · Cited by 548
Self-citationAfshin, A., Micha, R., Khatibzadeh, S., & Mozaffarian, D. (2014) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.076901 · Cited by 509
Anand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.050 · Cited by 507
“Legumes also reduce systolic blood pressure (by 2 mm Hg) and lowered mean arterial pressure (231) in a meta-analysis of 8 RCTs.”
BackgroundNutritional and health benefits of pulses
Mudryj, A. N., Yu, N., & Aukema, H. M. (2014) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2013-0557 · Cited by 424
Pérez‐Martínez, P., Mikhailidis, D. P., Athyros, V. G., Bulló, M., Couture, P., Covas, M. I., de Koning, L., Delgado‐Lista, J., Díaz‐López, A., Drevon, C. A., et al. (2017) · Nutrition Reviews · doi:10.1093/nutrit/nux014 · Cited by 429
Metadata
- Authors
- Jayalath, V. H., de Souza, R. J., Sievenpiper, J. L., Ha, V., Chiavaroli, L., Mirrahimi, A., Di Buono, M., Bernstein, A. M., Leiter, L. A., Kris-Etherton, P. M., Vuksan, V., Beyene, J., Kendall, C. W. C., & Jenkins, D. J. A.
- Affiliations
- St. Michael's Hospital (CA)
- Cleveland Clinic (US)
- McMaster University (CA)
- ORCID
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-09-07
- Volume
- 27
- Issue
- 1
- Pages
- 56-64
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- PMC
- PMC5391775
- OpenAlex
- W2107126748
- Cited by
- 173
- References
- 50
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 18 · 2023: 10 · 2022: 17 · 2021: 10 · 2020: 24 · 2019: 21 · 2018: 14 · 2017: 13 · 2016: 14 · 2015: 9 · 2014: 10 · 2013: 1
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- American Journal of Hypertension (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Abbott Laboratories
- Coca-Cola Foundation
- Canadian Nutrition Society
- Government of Canada
- European Association for the Study of Diabetes
- National Institutes of Health
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- Fabaceae, blood pressure, hypertension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, isocaloric substitution, dietary guidelines, plant-based diet
- MeSH terms
- Blood Pressure, Diet, Humans, Hypertension, Fabaceae, Primary Prevention, Risk Factors, Seeds, Time Factors, Chi-Square Distribution, Treatment Outcome, Risk Reduction Behavior
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