Cochrane · systematic review · CD009825
Mediterranean‐style diet for the primary and secondary prevention of cardiovascular disease
Rees, K, Takeda, A, Martin, N, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
38
current version
GRADE rated
33
No studies
4
Included studies
NR
No studies 4 · 10.5%Ungraded 1 · 2.6%Very low 8 · 21.1%Low 17 · 44.7%Moderate 8 · 21.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Mediterranean dietary intervention compared to no intervention or minimal intervention for the primary prevention of cardiovascular disease
Population: adults without cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
CVD mortality Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | NR | No studies |
Total mortality Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | NR | No studies |
Total cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 5 studies · 569 participants | Low Downgraded: risk of bias |
LDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 4 studies · 389 participants | Very low Downgraded: risk of bias |
HDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 5 studies · 569 participants | Low Downgraded: risk of bias |
Triglycerides (mmol/L), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 4 studies · 480 participants | Low Downgraded: risk of bias |
Systolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 2 studies · 269 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Diastolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | 2 studies · 269 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Mediterranean dietary intervention vs no intervention or minimal intervention | no estimate extracted | NR | No studies |
Mediterranean dietary intervention compared to another dietary intervention for the primary of cardiovascular disease
Population: adults without cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
CVD mortality Mediterranean dietary intervention vs another dietary intervention | HR 0.81 [0.5, 1.32] | 1 study · 7447 participants | Low Downgraded: imprecision |
Total mortality Mediterranean dietary intervention vs another dietary intervention | HR 1 [0.81, 1.24] | 1 study · 7447 participants | Low Downgraded: imprecision |
Myocardial infarction Mediterranean dietary intervention vs another dietary intervention | HR 0.79 [0.57, 1.1] | 1 study · 7447 participants | Low Downgraded: imprecision |
Stroke Mediterranean dietary intervention vs another dietary intervention | HR 0.6 [0.45, 0.8] | 1 study · 7447 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Peripheral arterial disease Mediterranean dietary intervention vs another dietary intervention | HR 0.42 [0.28, 0.61] | 1 study · 7447 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Total cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 7 studies · 939 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
LDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 7 studies · 947 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
HDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 6 studies · 891 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Triglycerides (mmol/L), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 7 studies · 939 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Systolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 4 studies · 448 participants | Low Downgraded: imprecision |
Diastolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 4 studies · 448 participants | Low Downgraded: imprecision |
Adverse events Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 1 study · 7447 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mediterranean dietary intervention compared to usual care for secondary prevention of cardiovascular disease
Population: adults with established cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
CVD mortality Mediterranean dietary intervention vs usual care | RR 0.35 [0.15, 0.82] | 1 study · 605 participants | Low Downgraded: risk of bias |
Total mortality Mediterranean dietary intervention vs usual care | RR 0.44 [0.21, 0.92] | 1 study · 605 participants | Low Downgraded: risk of bias |
Total cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 2 studies · 441 participants | Low Downgraded: risk of bias, imprecision |
LDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 2 studies · 441 participants | Low Downgraded: risk of bias, imprecision |
HDL cholesterol (mmol/L), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 2 studies · 441 participants | Low Downgraded: risk of bias, imprecision |
Triglycerides (mmol/L), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 2 studies · 441 participants | Low Downgraded: risk of bias, imprecision |
Systolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 1 study · 339 participants | Very low Downgraded: risk of bias |
Diastolic blood pressure (mmHg), change from baseline Mediterranean dietary intervention vs usual care | no estimate extracted | 1 study · 339 participants | Very low Downgraded: risk of bias |
Adverse events Mediterranean dietary intervention vs usual care | no estimate extracted | 1 study · 605 participants | Low Downgraded: risk of bias |
Mediterranean dietary intervention compared to another dietary intervention for the secondary prevention of cardiovascular disease
Population: adults with established cardiovascular disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total cardiac endpoints (all‐cause and cardiac deaths, myocardial infarction, hospital admissions for heart failure, unstable angina or stroke, unadjusted) Mediterranean dietary intervention vs another dietary intervention | RR 0.98 [0.4, 2.41] | 1 study · 101 participants | Very low Downgraded: risk of bias |
Total cholesterol (mmol/L), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 0 studies · 0 participants | Ungraded |
LDL cholesterol (mmol/L), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias |
HDL cholesterol (mmol/L), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 1 study · 71 participants | Low Downgraded: risk of bias |
Triglycerides (mmol/L), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias |
Systolic blood pressure (mmHg), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 2 studies · 150 participants | Very low Downgraded: risk of bias, imprecision |
Diastolic blood pressure (mmHg), change from baseline (sensitivity analysis without Singh studies) Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | 2 studies · 150 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Mediterranean dietary intervention vs another dietary intervention | no estimate extracted | NR | No studies |