Sesame and cardiovascular balance: a GRADE-assessed systematic review and meta-analysis of its role in modulating risk factors among individuals with prehypertension and hypertension
This systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals. A systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on...
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| Published in: | Clinical hypertension Vol. 31; no. 1; p. e33 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Korea (South)
대한고혈압학회
2025
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| ISSN: | 2056-5909, 2635-6325, 2056-5909 |
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| Abstract | This systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals.
A systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on blood pressure, anthropometric indices, lipid profiles, and oxidative stress markers. Study quality and evidence strength were assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively.
Six trials, with interventions ranging from 4 to 8 weeks and involving 465 participants, reported reductions in body mass index (weighted mean difference [WMD], -3.00 kg/m
; 95% confidence interval [CI], -3.43 to -2.57;
< 0.001), weight (WMD, -7.51 kg; 95% CI, -8.64 to -6.37;
< 0.001), diastolic blood pressure (WMD, -16.29 mmHg; 95% CI, -25.37 to -7.22;
< 0.001), systolic blood pressure (WMD, -20.78 mmHg; 95% CI, -32.26 to -9.31;
< 0.001), high-density lipoprotein cholesterol (WMD, 2.21 mg/dL; 95% CI, 0.09 to 4.33;
= 0.041), total cholesterol (WMD, -49.29 mg/dL; 95% CI, -96.71 to -1.86;
= 0.042), triglycerides (WMD, -55.05 mg/dL; 95% CI, -79.51, -30.59;
< 0.001), catalase (WMD, 3.38 U/mg of protein; 95% CI, 3.24 to 3.52;
< 0.001), erythrocyte glutathione peroxidase (WMD, 0.93 U/min/mg of hemoglobin [Hb]; 95% CI, 0.38 to 1.47;
= 0.001), erythrocyte superoxide dismutase (WMD, 3.11 U/ mg of Hb; 95% CI, 2.92 to 3.29;
< 0.001), and thiobarbituric acid reactive substances (WMD, -2.94 nmol/dL; 95% CI, -3.99 to -1.89;
< 0.001). In contrast, no significant effects were observed on low-density lipoprotein cholesterol or malondialdehyde). However, the GRADE assessment rated the evidence as very low across all outcomes due to high heterogeneity, small sample sizes, and methodological limitations, rendering the clinical plausibility of these findings uncertain.
While sesame supplementation showed apparent improvements in several cardiovascular risk factors, the very low certainty of evidence, driven by study limitations and implausible effect sizes, precludes definitive conclusions. High-quality, well-designed randomized controlled trials are needed to clarify sesame's therapeutic role in prehypertension and hypertension.
PROSPERO Identifier: CRD42025634033. |
|---|---|
| AbstractList | This systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals.BackgroundThis systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals.A systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on blood pressure, anthropometric indices, lipid profiles, and oxidative stress markers. Study quality and evidence strength were assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively.MethodsA systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on blood pressure, anthropometric indices, lipid profiles, and oxidative stress markers. Study quality and evidence strength were assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively.Six trials, with interventions ranging from 4 to 8 weeks and involving 465 participants, reported reductions in body mass index (weighted mean difference [WMD], -3.00 kg/m2; 95% confidence interval [CI], -3.43 to -2.57; P < 0.001), weight (WMD, -7.51 kg; 95% CI, -8.64 to -6.37; P < 0.001), diastolic blood pressure (WMD, -16.29 mmHg; 95% CI, -25.37 to -7.22; P < 0.001), systolic blood pressure (WMD, -20.78 mmHg; 95% CI, -32.26 to -9.31; P < 0.001), high-density lipoprotein cholesterol (WMD, 2.21 mg/dL; 95% CI, 0.09 to 4.33; P = 0.041), total cholesterol (WMD, -49.29 mg/dL; 95% CI, -96.71 to -1.86; P = 0.042), triglycerides (WMD, -55.05 mg/dL; 95% CI, -79.51, -30.59; P < 0.001), catalase (WMD, 3.38 U/mg of protein; 95% CI, 3.24 to 3.52; P < 0.001), erythrocyte glutathione peroxidase (WMD, 0.93 U/min/mg of hemoglobin [Hb]; 95% CI, 0.38 to 1.47; P = 0.001), erythrocyte superoxide dismutase (WMD, 3.11 U/ mg of Hb; 95% CI, 2.92 to 3.29; P < 0.001), and thiobarbituric acid reactive substances (WMD, -2.94 nmol/dL; 95% CI, -3.99 to -1.89; P < 0.001). In contrast, no significant effects were observed on low-density lipoprotein cholesterol or malondialdehyde). However, the GRADE assessment rated the evidence as very low across all outcomes due to high heterogeneity, small sample sizes, and methodological limitations, rendering the clinical plausibility of these findings uncertain.ResultsSix trials, with interventions ranging from 4 to 8 weeks and involving 465 participants, reported reductions in body mass index (weighted mean difference [WMD], -3.00 kg/m2; 95% confidence interval [CI], -3.43 to -2.57; P < 0.001), weight (WMD, -7.51 kg; 95% CI, -8.64 to -6.37; P < 0.001), diastolic blood pressure (WMD, -16.29 mmHg; 95% CI, -25.37 to -7.22; P < 0.001), systolic blood pressure (WMD, -20.78 mmHg; 95% CI, -32.26 to -9.31; P < 0.001), high-density lipoprotein cholesterol (WMD, 2.21 mg/dL; 95% CI, 0.09 to 4.33; P = 0.041), total cholesterol (WMD, -49.29 mg/dL; 95% CI, -96.71 to -1.86; P = 0.042), triglycerides (WMD, -55.05 mg/dL; 95% CI, -79.51, -30.59; P < 0.001), catalase (WMD, 3.38 U/mg of protein; 95% CI, 3.24 to 3.52; P < 0.001), erythrocyte glutathione peroxidase (WMD, 0.93 U/min/mg of hemoglobin [Hb]; 95% CI, 0.38 to 1.47; P = 0.001), erythrocyte superoxide dismutase (WMD, 3.11 U/ mg of Hb; 95% CI, 2.92 to 3.29; P < 0.001), and thiobarbituric acid reactive substances (WMD, -2.94 nmol/dL; 95% CI, -3.99 to -1.89; P < 0.001). In contrast, no significant effects were observed on low-density lipoprotein cholesterol or malondialdehyde). However, the GRADE assessment rated the evidence as very low across all outcomes due to high heterogeneity, small sample sizes, and methodological limitations, rendering the clinical plausibility of these findings uncertain.While sesame supplementation showed apparent improvements in several cardiovascular risk factors, the very low certainty of evidence, driven by study limitations and implausible effect sizes, precludes definitive conclusions. High-quality, well-designed randomized controlled trials are needed to clarify sesame's therapeutic role in prehypertension and hypertension.ConclusionsWhile sesame supplementation showed apparent improvements in several cardiovascular risk factors, the very low certainty of evidence, driven by study limitations and implausible effect sizes, precludes definitive conclusions. High-quality, well-designed randomized controlled trials are needed to clarify sesame's therapeutic role in prehypertension and hypertension.PROSPERO Identifier: CRD42025634033.Trial RegistrationPROSPERO Identifier: CRD42025634033. This systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals. A systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on blood pressure, anthropometric indices, lipid profiles, and oxidative stress markers. Study quality and evidence strength were assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively. Six trials, with interventions ranging from 4 to 8 weeks and involving 465 participants, reported reductions in body mass index (weighted mean difference [WMD], -3.00 kg/m ; 95% confidence interval [CI], -3.43 to -2.57; < 0.001), weight (WMD, -7.51 kg; 95% CI, -8.64 to -6.37; < 0.001), diastolic blood pressure (WMD, -16.29 mmHg; 95% CI, -25.37 to -7.22; < 0.001), systolic blood pressure (WMD, -20.78 mmHg; 95% CI, -32.26 to -9.31; < 0.001), high-density lipoprotein cholesterol (WMD, 2.21 mg/dL; 95% CI, 0.09 to 4.33; = 0.041), total cholesterol (WMD, -49.29 mg/dL; 95% CI, -96.71 to -1.86; = 0.042), triglycerides (WMD, -55.05 mg/dL; 95% CI, -79.51, -30.59; < 0.001), catalase (WMD, 3.38 U/mg of protein; 95% CI, 3.24 to 3.52; < 0.001), erythrocyte glutathione peroxidase (WMD, 0.93 U/min/mg of hemoglobin [Hb]; 95% CI, 0.38 to 1.47; = 0.001), erythrocyte superoxide dismutase (WMD, 3.11 U/ mg of Hb; 95% CI, 2.92 to 3.29; < 0.001), and thiobarbituric acid reactive substances (WMD, -2.94 nmol/dL; 95% CI, -3.99 to -1.89; < 0.001). In contrast, no significant effects were observed on low-density lipoprotein cholesterol or malondialdehyde). However, the GRADE assessment rated the evidence as very low across all outcomes due to high heterogeneity, small sample sizes, and methodological limitations, rendering the clinical plausibility of these findings uncertain. While sesame supplementation showed apparent improvements in several cardiovascular risk factors, the very low certainty of evidence, driven by study limitations and implausible effect sizes, precludes definitive conclusions. High-quality, well-designed randomized controlled trials are needed to clarify sesame's therapeutic role in prehypertension and hypertension. PROSPERO Identifier: CRD42025634033. Background: This systematic review aimed to evaluate the clinical effectiveness of sesame supplementation on cardiovascular health parameters in pre-hypertensive and hypertensive individuals. Methods: A systematic search was conducted up to August 2024.Eligible studies evaluated the effects of sesame supplementation on blood pressure, anthropometric indices, lipid profiles, and oxidative stress markers. Study quality and evidence strength were assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, respectively. Results: Six trials, with interventions ranging from 4 to 8 weeks and involving 465 participants, reported reductions in body mass index (weighted mean difference [WMD], −3.00 kg/m2; 95% confidence interval [CI], −3.43 to −2.57; P < 0.001), weight (WMD, −7.51 kg; 95% CI, −8.64 to −6.37; P < 0.001), diastolic blood pressure (WMD, −16.29 mmHg; 95% CI, −25.37 to −7.22; P < 0.001), systolic blood pressure (WMD, −20.78 mmHg; 95% CI, −32.26 to −9.31; P < 0.001), high-density lipoprotein cholesterol (WMD, 2.21 mg/dL; 95% CI, 0.09 to 4.33; P = 0.041), total cholesterol (WMD, −49.29 mg/dL; 95% CI, −96.71 to −1.86; P = 0.042), triglycerides (WMD, −55.05 mg/dL; 95% CI, −79.51, −30.59; P < 0.001), catalase (WMD, 3.38 U/mg of protein; 95% CI, 3.24 to 3.52; P < 0.001), erythrocyte glutathione peroxidase (WMD, 0.93 U/min/mg of hemoglobin [Hb]; 95% CI, 0.38 to 1.47; P = 0.001), erythrocyte superoxide dismutase (WMD, 3.11 U/ mg of Hb; 95% CI, 2.92 to 3.29; P < 0.001), and thiobarbituric acid reactive substances (WMD, −2.94 nmol/dL; 95% CI, −3.99 to −1.89; P < 0.001). In contrast, no significant effects were observed on low-density lipoprotein cholesterol or malondialdehyde). However, the GRADE assessment rated the evidence as very low across all outcomes due to high heterogeneity, small sample sizes, and methodological limitations, rendering the clinical plausibility of these findings uncertain. Conclusions: While sesame supplementation showed apparent improvements in several cardiovascular risk factors, the very low certainty of evidence, driven by study limitations and implausible effect sizes, precludes definitive conclusions. High-quality, well-designed randomized controlled trials are needed to clarify sesame's therapeutic role in prehypertension and hypertension. Trial Registration: PROSPERO Identifier: CRD42025634033 KCI Citation Count: 0 |
| Author | Musazadeh, Vali Jafari, Ali Fashtali, Zahra Mirzaei Ardakany, Sara Jamei Mardani, Helia Ghalichi, Faezeh Yousefabady, Matin Abdollahi Mohajerani, Arefeh |
| Author_xml | – sequence: 1 givenname: Helia orcidid: 0009-0003-2323-3464 surname: Mardani fullname: Mardani, Helia organization: Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran – sequence: 2 givenname: Faezeh orcidid: 0000-0002-3504-8069 surname: Ghalichi fullname: Ghalichi, Faezeh organization: Department of Nutrition Sciences, Maragheh University of Medical Sciences, Maragheh, Iran – sequence: 3 givenname: Zahra Mirzaei orcidid: 0009-0000-5854-7496 surname: Fashtali fullname: Fashtali, Zahra Mirzaei organization: Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran – sequence: 4 givenname: Sara Jamei orcidid: 0009-0005-4507-4454 surname: Ardakany fullname: Ardakany, Sara Jamei organization: Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran – sequence: 5 givenname: Matin Abdollahi orcidid: 0000-0002-7695-1000 surname: Yousefabady fullname: Yousefabady, Matin Abdollahi organization: Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran – sequence: 6 givenname: Arefeh orcidid: 0000-0001-8631-4921 surname: Mohajerani fullname: Mohajerani, Arefeh organization: Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran., Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran – sequence: 7 givenname: Vali orcidid: 0000-0002-4978-9474 surname: Musazadeh fullname: Musazadeh, Vali organization: Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran., Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran – sequence: 8 givenname: Ali orcidid: 0000-0001-7343-027X surname: Jafari fullname: Jafari, Ali organization: Student Research Committee, Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/41089589$$D View this record in MEDLINE/PubMed https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART003252655$$DAccess content in National Research Foundation of Korea (NRF) |
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| Cites_doi | 10.1136/bmj.39489.470347.AD 10.1111/j.1751-7176.2012.00649.x 10.1007/978-3-319-78030-6_59 10.1016/j.clnu.2010.11.005 10.1007/s40200-025-01656-y 10.1016/S1081-1206(10)61181-7 10.1002/9781119536604.ch8 10.1097/01.shk.0000172366.73881.c7 10.1161/HYPERTENSIONAHA.109.139352 10.1016/j.jacl.2015.12.011 10.1016/j.phrs.2025.107882 10.1002/sim.1186 10.1248/bpb.21.469 10.1194/jlr.M200318-JLR200 10.1016/S0026-0495(00)91117-X 10.1016/j.ijcard.2021.01.070 10.3389/fphys.2017.00196 10.1016/j.ocsci.2022.05.003 10.1016/S0741-5214(03)01038-3 10.1186/s41043-025-00967-3 10.1080/10408398.2021.1888689 10.1136/bmj.b1665 10.1002/jsfa.8361 10.1177/2047487316675194 10.1177/107424849900400403 10.1186/2046-4053-4-1 10.1080/87559129.2019.1683744 10.3177/jnsv.55.87 10.1186/s12986-025-00910-7 10.1038/s41581-019-0244-2 10.1177/2047487312437625 10.1136/bmj.315.7109.629 10.1186/1475-2891-10-82 10.1089/jmf.2006.9.408 10.1155/2021/6622981 10.1016/j.dsx.2025.103264 10.1161/01.HYP.30.3.646 |
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| Keywords | Hypertension Dietary intervention Blood pressure Metabolic factors Meta-analysis Sesame |
| Language | English |
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