Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: systematic review and network meta-analysis
Network meta-analysis of 67 dietary RCTs (n=17230): DASH, Mediterranean, low-carbohydrate, Palaeolithic, high-protein, low-GI, low-sodium, and low-fat diets each lowered systolic blood pressure more than control (−8.73 to −2.32 mmHg range across diets); DASH had the highest surface-under-the-cumulative-ranking curve probability for systolic and diastolic BP lowering.
Design
- 67 RCTs, 13 dietary approaches, n = 17,230 hypertensive or pre-hypertensive adults
- ≥12 weeks intervention; network meta-analysis of post-intervention SBP/DBP (random effects)
Comparative BP signals (abstract language)
DASH, Mediterranean, low-carb, Palaeolithic, high-protein, low-GI, low-sodium, low-fat each significantly reduced SBP (−8.73 to −2.32 mmHg) and DBP (−4.85 to −1.27 mmHg) vs control.
Ranking (SUCRA)
DASH ranked #1 for lowering SBP (90%) and DBP (91%); Palaeolithic second for SBP; Mediterranean third for DBP in SUCRA narrative (read paper for full league tables).
Evidence hygiene
Credibility rated very low to moderate for most pairwise contrasts except DASH vs low-fat (high quality) per abstract—do not over-interpret Palaeolithic rank versus long-term adherence realities.
Publication
Schwingshackl L, Chaimani A, Schwedhelm C, et al. Crit Rev Food Sci Nutr. 2019;59(16):2674-2687. Epub 2018 May 24. PMID 29718689.
Outcomes
- Network meta-analysis (67 RCTs, n=17,230): DASH diet highest SUCRA for SBP lowering (90%) and DBP lowering (91%) among 13 dietary approaches; significant SBP reductions vs control ranged −8.73 to −2.32 mmHg across diets.