Abstract
We systematically retrieved and summarised clinical studies on traditional Chinese medicine (TCM) for the prevention and treatment of essential hypertension (EH) using the evidence map. We aimed to explore the evidence distribution, identify gaps in evidence, and inform on future research priorities. Clinical studies, systematic reviews, guidelines, and pathway studies related to TCM for the prevention and treatment of EH, published between January 2000 and December 2019, were included from databases CNKI, WanFang Data, VIP, PubMed, Embase, and Web of Science. The distribution of evidence was analysed using text descriptions, tables, and graphs. A total of 9,403 articles were included, including 5,920 randomised controlled studies (RCTs), 16 guidelines, expert consensus and path studies, and 139 systematic reviews (SRs). The articles publishing trend increased over time. This study showed that the intervention time of TCM was concentrated at 4–8 weeks, mainly through Chinese herbal medicine (CHM) for the prevention and treatment of elderly hypertension and the complications. A Measurement Tool to Assess Systematic Reviews (AMSTAR) scores of the included reviews ranged from 2 to 10. Most of the SRs had a potentially positive effect (n = 120), mainly in 5–8 score. Primary studies and SRs show potential benefits of TCM in lowering blood pressure, lowering the TCM syndrome and symptom differentiation scores (TCM-SSD scores), improving the total effective rate, and reducing the adverse events. The adjunctive effect of TCM on improving the total effective rate, lowering the blood pressure, lowering the TCM-SSD scores, and lowering the adverse effects was only supported by low-quality evidence in this research. The evidence map was used to show the overall research on TCM for the treatment of EH; however, due to the existing problems of the primary studies, the current research conclusion needs further research with higher quality and standardisation.
Highlights
Hypertension has become a primary global disease and is an important global public health challenge [1]
English database retrieval was divided into two parts. e search terms for the first retrieval included: (“hypertension” OR “blood pressure, high” OR “blood pressures, high” OR “high blood pressure” OR “high blood pressures”) AND (“medicine, Chinese traditional” OR “traditional Chinese medicine” OR “traditional medicine, Chinese” OR “Chinese medicine, traditional” OR “herbal medicine” OR “drugs, Chinese herbal” OR “herbal formula” OR “Chinese herbal medicine” OR “Chinese herb therapy” OR “Chinese herb” OR “herb therapy” OR “herbal remedy” OR “acupuncture”). e second retrieval search term was “hypertension” + hypertension-related formulas and nondrug therapy that frequently appeared in the meta-analysis in the Chinese database; the two retrievals were combined
(2) Type of participants: the patients that met the diagnostic criteria of essential hypertension. ere was no limitation on the age, sex, race, time of onset, and cases of the source
Summary
Hypertension has become a primary global disease and is an important global public health challenge [1]. In 2000, 26.4% of adults worldwide suffered from high blood pressure. It is estimated that by 2025, 29.2% of people in the world will suffer from high blood pressure [2]. Ere is currently an upward trend of the hypertension prevalence and mortality rates among Chinese residents and it is predicted that by 2030, the annual economic burden of cardiovascular disease deaths caused by hypertension in China will reach $6–9 million [3]. Systematic reviews (SRs) have shown that traditional Chinese medicine (TCM) has a significant effect on lowering blood pressure but there is little research on its underlying intervention mechanisms [6, 7]
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