Quality Assessment of Global Guidelines on Diet Intervention for Hypertension_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENXiao-fan ^1,2 ,  LIYou-ping ¹ , CHENZhi-kang ² , QIUYan-yu ² , HUANGShao-tong ²

1. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China;

Corresponding author：

LIYou-ping, Email: yzmylab@hotmail.com

Keywords：

Hypertension; Diet; Guideline; AGREE Ⅱ

DOI：

10.7507/1672-2531.20150009

Video：

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Objective To review guidelines on diet intervention for hypertension, compare the similarities/differences and the regularity of the guidelines, discuss the prevention and treatment effects of diet intervention for hypertension, promote the understanding of the guide, and to explore the best method of diet intervention for hypertension. Methods Database such as CNKI, EMbase, PubMed, etc., as well as guideline websites were searched from inception to February 28^th, 2014, for collecting guidelines on diet intervention in the prevention and treatment of hypertension. The Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ) were applied to assess methodological quality of the guidelines. Characteristics of diets recommended by the guidelines were analyzed through comparing the different regions and quality levels of the guidelines. Results A total of 27 guidelines on diet intervention for hypertension were included. They were formulated by 5 continents, 9 countries, 2 regions (Taiwan of China and Europe), and 1 international organization (WHO). According to the AGREE Ⅱ instrument, 13 guidelines were graded as Level A (recommendation) and 14 were graded as Level B (recommended after changes), respectively. The domains were more than 60% except for "rigor of development" (57.89±7.71)% and "applicability" (58.39±6.29)%. Each guideline recommended low sodium diet (usually:5 to 6 g/d; Oceania:4 g/d; North America:the amount of sodium intake should be decreased as age increases). The amount of alcohol intake was generally 30 mL/d for men and 20 mL/d for women. All included guidelines recommended to increase the intake of fruits, vegetables, and potassium. Conclusion Currently, more than half of diet intervention recommendations for hypertension in different countries and regions are still needs to be improved and modified. Diet recommendations differ in regions, gender, and age.

Citation： CHENXiao-fan, LIYou-ping, CHENZhi-kang, QIUYan-yu, HUANGShao-tong. Quality Assessment of Global Guidelines on Diet Intervention for Hypertension. Chinese Journal of Evidence-Based Medicine, 2015, 15(1): 36-46. doi: 10.7507/1672-2531.20150009 Copy

1.	中国高血压防治指南修订委员会. 中国高血压防治指南2010. 中国医学前沿杂志, 2011, 3(5):42-93.
2.	Véronique LR, Alan SG, Donald ML, et al. Heart disease and stroke statistics-2011 update:a report from the American heart association. Circulation, 2011, 123(4):e18-e209.
3.	Writing Group Members, Véronique LR, Alan SG, et al. Heart Disease and Stroke Statistics-2012 Update:A Report From the American Heart Association. Circulation, 2012, 125(1):e2-e220.
4.	Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men. JAMA, 2002, 287(8):1003-1010.
5.	Feigin VL, Barker-Collo S, Krishnamurthi R, et al. Epidemiology of ischaemic stroke and traumatic brain injury. Best Pract Res Clin Anaesthesiol, 2010, 24(4):485-494.
6.	GBD group. GBD 2010:design, definitions, and metrics. Lancet, 2012, 380(9859):2063-2066.
7.	郑碧辉, 林莘, 郑敏钦, 等. 中药药茶治疗高血压的临床疗效观察. 中国老年保健医学, 2012, 10(4):38-39.
8.	Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension:The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28(12):1462-1536.
9.	罗卫平, 刘来新, 马江平, 等. 2010年新疆监测点居民慢性病及其行为危险因素调查分析. 疾病预防控制通报, 2013, 28(1):20-23.
10.	Brouwers M, Kho ME, Browman GP, et al. AGREE Ⅱ:Advancing guideline development, reporting and evaluation in healthcare. Can Med Assoc J, 2010, 182(10):e839-e842.
11.	Shrout PE, Fleiss JL. Intraclass correlations:uses in assessing rater reliability. Psyhchol Bull, 1979, 86(2):420-428.
12.	Burgers JS, Fervers B, Haugh M, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol, 2004, 22(10):2000-2007.
13.	Carneiro AV. Methodological appraisal of guideline. The AGREE instrument. Rev Port Cardiol, 2004, 23(3):447-456.
14.	Wegman A, vander Windt D, van Tulder M, et al. Nonsteroidal antiinflammatory drugs or acetaminophen for osteoarthritis of the hipor knee? A systematic review of evidence and guidelines. J Rheumatol, 2004, 31(2):344-354.
15.	Fervers B, Burgers JS, Haugh MC, et al. Predictors of high quality clinical practice guidelines:examples in oncology. Int J Qual Health Care, 2005, 17(2):123-132.
16.	中国高血压防治指南修订委员会. 中国高血压防治指南2000. 高血压杂志, 2000, 8(2):103-112.
17.	中国高血压防治指南修订委员会.中国高血压防治指南2005. Available at:http://www.365heart.com/show/10246.shtml.
18.	Chiang CE, Wang TD, Li YH, et al. 2010 Guidelines of the Taiwan Society of Cardiology for the Management of Hypertension. J Formos Med Assoc, 2010, 109(10):740-773.
19.	Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2004). Hypertens Res, 2006, 29(3):S1-105.
20.	Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009). Hypertension Res, 2009, 32(1):70-77.
21.	Park JB. 2004 Korean Hypertension Treatment Guideline and Its Perspective. Korean Circulation J, 2006, 36(1):405-410.
22.	Milne FJ, Pinkney AVJ, Southern African Hypertension Society Hypertension Guideline Working Groups 2000 and 2003. Hypertension Guideline 2003 Update. SAMJ, 2004, 94(3 Pt 2):209-225.
23.	Seedat YK, Rayner BL. South African Hypertension Guideline 2011. SAMJ, 2012, 102(1):60-83.
24.	ANAES/Professional Recommendations and Guidelines Department and Economic Evaluation department. Management of adults with essential hypertension Clinical practice recommendations and economic data. April 2000. Available at:http://www.besancon-cardio.org/recommandations/hypertension_resume.pdf.
25.	Douglas JG, Bakris GL, Epstein M, et al. Management of High Blood Pressure in African Americans. Arch Interen Med, 2003, 163(5):525-541.
26.	Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults:2007 update:a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke, 2007, 38(6):2001-2023.
27.	Chobanian AV, Bakris GL, Black HR, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA, 2003, 289(19):2560-2572.
28.	Khan NA, McAlister FA, Rabkin SW, et al. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension:Part II -Therapy. Can J Cardiol Vol, 2006, 22(7):583-593.
29.	Khan NA, Hemmelgarn B, Padwal R, et al. The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension:Part 2-therapy. Can J Cardiol, 2007, 23(7):539-550.
30.	2009 CHEP Recommendations for the Management of Hypertension. Can J Cardiol, 2009, 25(5):271-277.
31.	Daskalopoulou SS, Khan AA, Quinn BR, et al. The 2012 Canadian Hypertension Education Program Recommendations for the Management of Hypertension:Blood Pressure Measurement, Diagnosis, Assessment of Risk, and Therapy. Can J Cardiol, 2012, 28(3):270-287.
32.	Sever P, Beevers G, Bulpitt C, et al. Management guidelines in essential hypertension:report of the second working party of the British Hypertension Society. BMJ, 1993, 306(6883):983-987.
33.	Ramsay LE, Williams B, Johnston GD, et al. Guidelines for management of hypertension:report of the third working party of the British Hypertension Society. J Hum Hypertens, 1999, 13(9):569-592.
34.	Williams B, Poulter NR, Brown MJ, et al. Guidelines for management of hypertension:report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens, 2004, 18(3):139-185.
35.	Gohlke H, Albus C, Gysan DB, et al. Cardiovascular Prevention in Clinical Practice (ESC and German Guidelines 2007). Herz, 2009, 34(1):4-14.
36.	de Backer G, Ambrosioni E, Borch JK, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts). Atherosclerosis, 2004, 173(2):381-391.
37.	Mancia G, de Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28(12):1462-1536.
38.	ESH, ESC. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Eur Heart J, 2013, 34(28):2108-2109.
39.	National Heart Goundation of Australia (National Blood pressure and Vascular Disease Advisory Committee). Guide to management of hypertension 2008. Updated December 2010.
40.	WHO, ISH Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension Writing Group (ISH) statement on management of hypertension. J Hypertens, 2003, 21(11):1983-1992.
41.	WHO. Prevention of Cardiovascular Disease, Guidelines for assessment and management of cardiovascular risk. WHO 2007.
42.	Shaneyfelt TM, Mayo Smith MF, Rothwangl J. Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA, 1999, 281(20):1900-1905.
43.	Grilli R, Magrini N, Penna A, et al. Practice guidelines developed by specialty societies:the need for a critical appraisal. Lancet, 2000, 355(9198):103-106.
44.	Graham ID, Beardall S, Carter AO, et al. What is the quality of drug therapy clinical practice guidelines in Canada? CMAJ, 2001, 165(2):157-163.
45.	McAlister FA, Campbell NR, Zarnke K, et al. The management of hypertension in Canada:a review of current guidelines, their short-comings and implications for the future. CMAJ, 2001, 164(4):517-522.
46.	Burgers JS, Fervers B, Haugh M, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol, 2004, 22(10):2000-2007.
47.	陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10):1180-1194.
48.	Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men:The Framingham Heart Study. JAMA, 2002, 287(16):1003-1010.
49.	陈捷, 赵秀丽, 武峰, 等. 我国14省市中老年人肥胖超重流行现状及其与高血压患病率的关系. 中华医学杂志, 2005, 85(40):2830-2834.
50.	Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics-2012 update:A report from the American heart association. Circulation, 2012, 125(1):188-197.
51.	陈晓凡, 李幼平, 喻佳洁. 从全球疾病负担看中国DRIs:挑战、证据与思考. 中国循证医学杂志, 2013, 13(10):1162-1171.

1. 中国高血压防治指南修订委员会. 中国高血压防治指南2010. 中国医学前沿杂志, 2011, 3(5):42-93.
2. Véronique LR, Alan SG, Donald ML, et al. Heart disease and stroke statistics-2011 update:a report from the American heart association. Circulation, 2011, 123(4):e18-e209.
3. Writing Group Members, Véronique LR, Alan SG, et al. Heart Disease and Stroke Statistics-2012 Update:A Report From the American Heart Association. Circulation, 2012, 125(1):e2-e220.
4. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men. JAMA, 2002, 287(8):1003-1010.
5. Feigin VL, Barker-Collo S, Krishnamurthi R, et al. Epidemiology of ischaemic stroke and traumatic brain injury. Best Pract Res Clin Anaesthesiol, 2010, 24(4):485-494.
6. GBD group. GBD 2010:design, definitions, and metrics. Lancet, 2012, 380(9859):2063-2066.
7. 郑碧辉, 林莘, 郑敏钦, 等. 中药药茶治疗高血压的临床疗效观察. 中国老年保健医学, 2012, 10(4):38-39.
8. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension:The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28(12):1462-1536.
9. 罗卫平, 刘来新, 马江平, 等. 2010年新疆监测点居民慢性病及其行为危险因素调查分析. 疾病预防控制通报, 2013, 28(1):20-23.
10. Brouwers M, Kho ME, Browman GP, et al. AGREE Ⅱ:Advancing guideline development, reporting and evaluation in healthcare. Can Med Assoc J, 2010, 182(10):e839-e842.
11. Shrout PE, Fleiss JL. Intraclass correlations:uses in assessing rater reliability. Psyhchol Bull, 1979, 86(2):420-428.
12. Burgers JS, Fervers B, Haugh M, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol, 2004, 22(10):2000-2007.
13. Carneiro AV. Methodological appraisal of guideline. The AGREE instrument. Rev Port Cardiol, 2004, 23(3):447-456.
14. Wegman A, vander Windt D, van Tulder M, et al. Nonsteroidal antiinflammatory drugs or acetaminophen for osteoarthritis of the hipor knee? A systematic review of evidence and guidelines. J Rheumatol, 2004, 31(2):344-354.
15. Fervers B, Burgers JS, Haugh MC, et al. Predictors of high quality clinical practice guidelines:examples in oncology. Int J Qual Health Care, 2005, 17(2):123-132.
16. 中国高血压防治指南修订委员会. 中国高血压防治指南2000. 高血压杂志, 2000, 8(2):103-112.
17. 中国高血压防治指南修订委员会.中国高血压防治指南2005. Available at:http://www.365heart.com/show/10246.shtml.
18. Chiang CE, Wang TD, Li YH, et al. 2010 Guidelines of the Taiwan Society of Cardiology for the Management of Hypertension. J Formos Med Assoc, 2010, 109(10):740-773.
19. Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2004). Hypertens Res, 2006, 29(3):S1-105.
20. Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009). Hypertension Res, 2009, 32(1):70-77.
21. Park JB. 2004 Korean Hypertension Treatment Guideline and Its Perspective. Korean Circulation J, 2006, 36(1):405-410.
22. Milne FJ, Pinkney AVJ, Southern African Hypertension Society Hypertension Guideline Working Groups 2000 and 2003. Hypertension Guideline 2003 Update. SAMJ, 2004, 94(3 Pt 2):209-225.
23. Seedat YK, Rayner BL. South African Hypertension Guideline 2011. SAMJ, 2012, 102(1):60-83.
24. ANAES/Professional Recommendations and Guidelines Department and Economic Evaluation department. Management of adults with essential hypertension Clinical practice recommendations and economic data. April 2000. Available at:http://www.besancon-cardio.org/recommandations/hypertension_resume.pdf.
25. Douglas JG, Bakris GL, Epstein M, et al. Management of High Blood Pressure in African Americans. Arch Interen Med, 2003, 163(5):525-541.
26. Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults:2007 update:a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke, 2007, 38(6):2001-2023.
27. Chobanian AV, Bakris GL, Black HR, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA, 2003, 289(19):2560-2572.
28. Khan NA, McAlister FA, Rabkin SW, et al. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension:Part II -Therapy. Can J Cardiol Vol, 2006, 22(7):583-593.
29. Khan NA, Hemmelgarn B, Padwal R, et al. The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension:Part 2-therapy. Can J Cardiol, 2007, 23(7):539-550.
30. 2009 CHEP Recommendations for the Management of Hypertension. Can J Cardiol, 2009, 25(5):271-277.
31. Daskalopoulou SS, Khan AA, Quinn BR, et al. The 2012 Canadian Hypertension Education Program Recommendations for the Management of Hypertension:Blood Pressure Measurement, Diagnosis, Assessment of Risk, and Therapy. Can J Cardiol, 2012, 28(3):270-287.
32. Sever P, Beevers G, Bulpitt C, et al. Management guidelines in essential hypertension:report of the second working party of the British Hypertension Society. BMJ, 1993, 306(6883):983-987.
33. Ramsay LE, Williams B, Johnston GD, et al. Guidelines for management of hypertension:report of the third working party of the British Hypertension Society. J Hum Hypertens, 1999, 13(9):569-592.
34. Williams B, Poulter NR, Brown MJ, et al. Guidelines for management of hypertension:report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens, 2004, 18(3):139-185.
35. Gohlke H, Albus C, Gysan DB, et al. Cardiovascular Prevention in Clinical Practice (ESC and German Guidelines 2007). Herz, 2009, 34(1):4-14.
36. de Backer G, Ambrosioni E, Borch JK, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts). Atherosclerosis, 2004, 173(2):381-391.
37. Mancia G, de Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28(12):1462-1536.
38. ESH, ESC. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Eur Heart J, 2013, 34(28):2108-2109.
39. National Heart Goundation of Australia (National Blood pressure and Vascular Disease Advisory Committee). Guide to management of hypertension 2008. Updated December 2010.
40. WHO, ISH Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension Writing Group (ISH) statement on management of hypertension. J Hypertens, 2003, 21(11):1983-1992.
41. WHO. Prevention of Cardiovascular Disease, Guidelines for assessment and management of cardiovascular risk. WHO 2007.
42. Shaneyfelt TM, Mayo Smith MF, Rothwangl J. Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA, 1999, 281(20):1900-1905.
43. Grilli R, Magrini N, Penna A, et al. Practice guidelines developed by specialty societies:the need for a critical appraisal. Lancet, 2000, 355(9198):103-106.
44. Graham ID, Beardall S, Carter AO, et al. What is the quality of drug therapy clinical practice guidelines in Canada? CMAJ, 2001, 165(2):157-163.
45. McAlister FA, Campbell NR, Zarnke K, et al. The management of hypertension in Canada:a review of current guidelines, their short-comings and implications for the future. CMAJ, 2001, 164(4):517-522.
46. Burgers JS, Fervers B, Haugh M, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol, 2004, 22(10):2000-2007.
47. 陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10):1180-1194.
48. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men:The Framingham Heart Study. JAMA, 2002, 287(16):1003-1010.
49. 陈捷, 赵秀丽, 武峰, 等. 我国14省市中老年人肥胖超重流行现状及其与高血压患病率的关系. 中华医学杂志, 2005, 85(40):2830-2834.
50. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics-2012 update:A report from the American heart association. Circulation, 2012, 125(1):188-197.
51. 陈晓凡, 李幼平, 喻佳洁. 从全球疾病负担看中国DRIs:挑战、证据与思考. 中国循证医学杂志, 2013, 13(10):1162-1171.

Chinese Journal of Evidence-Based Medicine

Quality Assessment of Global Guidelines on Diet Intervention for Hypertension

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