Background

Previous clinical studies have shown controversial results regarding the effect of inorganic nitrate supplementation on blood pressure (BP) in older individuals. We performed this systematic review and meta-analysis to assess the effect of inorganic nitrate on BP in older adults.

Methods

Eligible studies were searched in Cochrane Library, PubMed, Scopus, Web of Science, and Embase. Randomized controlled trials which evaluated the effect of inorganic nitrate consumption on BP in older adults were recruited. The random-effect model was used to calculate the pooled effect sizes.

Results

22 studies were included in this meta-analysis. Overall, inorganic nitrate consumption significantly reduced systolic blood pressure (SBP) by −3.90 mmHg (95% confidence interval: −5.23 to −2.57; P < 0.001) and diastolic blood pressure (DBP) by −2.62 mmHg (95% confidence interval: −3.86 to −1.37; P < 0.005) comparing with the control group. Subgroup analysis showed that the BP was significantly reduced when participants' age≥65, BMI>30, or baseline BP in prehypertension stage. And both SBP and DBP decreased significantly after acute nitrate supplementation of a single dose (<1 day) or more than 1-week. However, participants with hypertension at baseline were not associated with significant changes in both SBP and DBP. Subgroup analysis of measurement methods showed that only the resting BP group showed a significant reduction in SBP and DBP, compared with the 24-h ambulatory BP monitoring (ABPM) group and daily home BP measurement group.

Conclusion

These results demonstrate that consuming inorganic nitrate can significantly reduce SBP and DBP in older adults, especially in whose age ≥ 65, BMI＞30, or baseline BP in prehypertension stage.

中文翻译：

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无机硝酸盐补充剂对老年人血压的影响：系统评价和荟萃分析

背景

先前的临床研究表明，无机硝酸盐补充剂对老年人血压 (BP) 的影响存在争议。我们进行了这项系统评价和荟萃分析，以评估无机硝酸盐对老年人血压的影响。

方法

在 Cochrane Library、PubMed、Scopus、Web of Science 和 Embase 中搜索了符合条件的研究。招募了评估无机硝酸盐摄入对老年人血压影响的随机对照试验。随机效应模型用于计算合并效应大小。

结果

该荟萃分析纳入了 22 项研究。总体而言，无机硝酸盐消耗显着降低收缩压 (SBP) -3.90 mmHg（95% 置信区间：-5.23 至 -2.57；P  < 0.001）和舒张压 (DBP) -2.62 mmHg（95% 置信区间： -3.86 至 -1.37；P < 0.005) 与对照组比较。亚组分析显示，当参与者年龄≥65岁、BMI>30或处于高血压前期的基线血压时，血压显着降低。单剂量（<1 天）或超过 1 周急性补充硝酸盐后，SBP 和 DBP 均显着下降。然而，基线时患有高血压的参与者与 SBP 和 DBP 的显着变化无关。测量方法的亚组分析显示，与 24 小时动态血压监测（ABPM）组和每日家庭血压测量组相比，只有静息血压组的 SBP 和 DBP 显着降低。

结论

这些结果表明，摄入无机硝酸盐可以显着降低老年人的 SBP 和 DBP，尤其是年龄≥65、BMI＞30 或处于高血压前期的基线血压。