Effects of Probiotics on Patients with Hypertension: a Systematic Review and Meta-analysis

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GUIDELINES / CLINICAL TRIALS/META-ANALYSIS (WJ KOSTIS, SECTION EDITOR)

Effects of Probiotics on Patients with Hypertension: a Systematic Review and Meta-analysis Cheng Chi 1,2 & Cheng Li 1,2 & Dongjun Wu 2 & Nicholas Buys 3 & Wenjun Wang 1 & Huimin Fan 4 & Jing Sun 2,4

# Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review This meta-analysis and systematic review was conducted to evaluate the effect of probiotics on blood pressure, body mass index (BMI), and blood glucose changes in patients with hypertension. Recent Findings We searched the PubMed, Cochrane, Embase, and ProQuest databases using a combination of MeSH and free text, from the inception of these databases to 20 January 2020, with no language restrictions. The quantitative Physiotherapy Evidence Database (PEDro) scale method was used to assess the quality of the included studies. We used the random effects models to estimate the outcomes, with heterogeneity among the studies assessed using Cochran’s Q statistic. Fourteen included studies published between 2002 and 2019 were included in the meta-analysis, reporting results of 846 hypertension participants. A significant reduction in SBP by − 2.05 mmHg (95% CI − 3.87, − 0.24, P = 0.03), DBP by − 1.26 mmHg (95% CI − 2.51, − 0.004, P = 0.047), BMI by − 1.03 (95% CI − 1.28, − 0.97, P < 0.01), and blood glucose by − 0.18 mmol/L (95% CI − 0.30, − 0.05, P = 0.007) was observed following probiotic intervention. Summary Our meta-analysis showed a modest but a significant reduction in SBP and DBP in patients with hypertension, particularly in those with diabetes mellitus, following probiotic supplementation. This effect was associated with treatment duration, dosage, and the age of subject, but was not associated with single or multiple strains usage. Additionally, probiotic supplement had a beneficial effect in reducing BMI and blood glucose. Keywords Probiotics . Blood pressure . Hypertension . Meta-analysis

Introduction Hypertension is a risk factor in many chronic diseases, including cardiovascular disease, kidney disease, and stroke [1–3]. The prevalence of hypertension globally is rising as a result of population aging and other risk factors including an unhealthy This article is part of the Topical Collection on Guidelines / Clinical Trials/Meta-Analysis * Jing Sun [email protected] 1

School of Nursing, Jining Medical University, Jining 272067, Shandong, China

2

School of Medicine, Griffith University, Parkland Drive, Gold Coast, QLD 4222, Australia

3

Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia

4

Shanghai East Hospital and School of Medicine, Tongji University, Shanghai, China

diet and lack of exercise. Globally, 26% of the world population (972 million people) has hypertension and this prevalence is expected to be increased to 29%. [4] Hypertension is a preventable and top modifiable risk factor and can be managed through interventions such as drug therapy, a healthy lifestyle, and good nutrition. [5] Wi