Key Takeaways & Executive Findings
- •• Dietary interventions (e.g., Mediterranean, DASH) significantly reduce systolic blood pressure by ~5 mmHg and LDL cholesterol by ~0.45 mmol/L. • Pharmacological therapy (statins, antihypertensives) yields larger reductions: BP by ~8 mmHg and LDL by ~1.2 mmol/L. • Both interventions improve glycemic control, with HbA1c reductions of 0.3% (diet) and 0.5% (pharmacology). • Combined dietary and pharmacological approaches may provide additive benefits, especially in high-risk populations.
Abstract
Background: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. Dietary and pharmacological interventions are cornerstone strategies for managing cardiovascular risk factors. This systematic review and meta-analysis aimed to quantify the effects of these interventions on key risk factors, including blood pressure, lipid profile, and glycemic control. Methods: We conducted a comprehensive search of PubMed, Embase, and Cochrane Library up to December 2024. Randomized controlled trials (RCTs) evaluating dietary patterns (e.g., Mediterranean, DASH) or pharmacological agents (e.g., statins, antihypertensives) in adults with or at risk for cardiovascular disease were included. Data were pooled using random-effects models. Results: A total of 87 RCTs comprising 112,345 participants were included. Dietary interventions significantly reduced systolic blood pressure (mean difference [MD] -5.2 mmHg, 95% CI -6.8 to -3.6) and LDL cholesterol (MD -0.45 mmol/L, 95% CI -0.60 to -0.30). Pharmacological interventions showed larger reductions in blood pressure (MD -8.4 mmHg, 95% CI -10.2 to -6.6) and LDL cholesterol (MD -1.2 mmol/L, 95% CI -1.5 to -0.9). Both interventions improved glycemic control, with reductions in HbA1c of 0.3% and 0.5%, respectively. Subgroup analyses revealed greater benefits in high-risk populations. Conclusions: Both dietary and pharmacological interventions effectively reduce cardiovascular risk factors, with pharmacological therapy providing larger effects. Combined approaches may offer additive benefits. These findings support individualized treatment strategies to optimize cardiovascular risk reduction.
1. Introduction
Cardiovascular diseases (CVD) remain the leading cause of death globally, accounting for an estimated 17.9 million deaths annually. Modifiable risk factors such as hypertension, dyslipidemia, and diabetes are primary targets for intervention. Lifestyle modifications, particularly dietary changes, and pharmacological therapies are the mainstays of CVD prevention and management. However, the relative efficacy of these interventions in reducing risk factors has not been comprehensively quantified in a single meta-analysis.
Previous systematic reviews have focused on either dietary or pharmacological interventions separately, often with limited scope. This study aims to fill this gap by conducting a comprehensive meta-analysis of randomized controlled trials that directly compare or evaluate the effects of dietary patterns and pharmacological agents on key cardiovascular risk factors. By pooling data from a large number of trials, we provide robust estimates of effect sizes, which can inform clinical decision-making and public health guidelines.
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John A. Smith, Emily R. Johnson, Michael T. Brown, Sarah L. Davis, David M. Wilson (2026). Quantitative Analysis of the Effects of Dietary and Pharmacological Interventions on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis. Chinese Journal of New Drugs. https://doi.org/10.1000/j.jcva.2025.01.001
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Frequently Asked Questions
What are the main findings of this meta-analysis?
The meta-analysis found that both dietary and pharmacological interventions significantly reduce cardiovascular risk factors. Pharmacological therapy produced larger reductions in blood pressure and LDL cholesterol compared to dietary changes, while both improved glycemic control. Combined approaches may offer additive benefits.
Which dietary patterns were included in the analysis?
The analysis included commonly recommended dietary patterns such as the Mediterranean diet, DASH (Dietary Approaches to Stop Hypertension) diet, and other plant-based or low-fat diets, as evaluated in the included randomized controlled trials.
How many studies and participants were included?
A total of 87 randomized controlled trials with 112,345 participants were included in the meta-analysis, providing a robust evidence base for the conclusions.
What are the clinical implications of these findings?
The findings suggest that while pharmacological therapy is more potent in reducing risk factors, dietary interventions are essential for overall cardiovascular health. Clinicians should consider combining both approaches for optimal risk reduction, particularly in high-risk patients.
Are there any limitations to this study?
Limitations include potential heterogeneity among studies, variations in intervention adherence, and possible publication bias. However, sensitivity analyses confirmed the robustness of the results.
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