Dietary interventions including caloric and carbohydrate restriction led to clinically meaningful improvements in blood pressure and body weight in HFpEF, though most studies had a high risk of bias.
Meta-Analysis
Do dietary interventions improve blood pressure, body weight, and function in patients with HFpEF or mixed heart failure?
Dietary interventions like caloric and carbohydrate restriction show potential to improve blood pressure and weight in HFpEF, though evidence quality is currently limited by bias and heterogeneity.
Abstract Aims To determine the efficacy of dietary interventions in Heart Failure with preserved Ejection Fraction (HFpEF). Method and results Keyword searches were performed in five bibliographic databases to identify randomized or controlled studies of dietary interventions conducted in HFpEF or mixed heart failure (HF) samples published in the English language. Studies were appraised for bias and synthesized into seven categories based on the similarity of the intervention or targeted population. The quality of the body of evidence was assessed via the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. Twenty-five unique interventions were identified; 17 were considered for meta-analysis. Most studies were judged to be at high risk of bias. There was moderate-quality evidence that caloric restriction led to clinically meaningful improvements in blood pressure and body weight. There was moderate-quality evidence that carbohydrate restriction resulted in meaningful reductions in blood pressure. There was very low-quality evidence that protein supplementation improved blood pressure and body weight and moderate-quality evidence for clinically meaningful improvements in function. Conclusions While some types of dietary interventions appeared to deliver clinically meaningful change in critical outcomes; the study heterogeneity and overall quality of the evidence make it difficult to make firm recommendations. Greater transparency when reporting the nutritional composition of interventions would enhance the ability to pool studies. Registration PROSPERO CRD42019145388.
Forsyth et al. (Thu,) conducted a meta-analysis in Heart Failure with preserved Ejection Fraction (HFpEF). Dietary interventions (caloric restriction, carbohydrate restriction, protein supplementation) was evaluated. Dietary interventions including caloric and carbohydrate restriction led to clinically meaningful improvements in blood pressure and body weight in HFpEF, though most studies had a high risk of bias.